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Khan J, Ali G, Saeed A, Khurshid A, Ahmad S, Kashtoh H, Ataya FS, Bathiha GES, Ullah A, Khan A. Efficacy assessment of novel methanimine derivatives in chronic constriction injury-induced neuropathic model: An in-vivo, ex-vivo and In-Silico approach. Eur J Pharm Sci 2024; 198:106797. [PMID: 38735401 DOI: 10.1016/j.ejps.2024.106797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Revised: 05/07/2024] [Accepted: 05/10/2024] [Indexed: 05/14/2024]
Abstract
The multicomponent etiology, complex clinical implications, dose-based side effect and degree of pain mitigation associated with the current pharmacological therapy is incapable in complete resolution of chronic neuropathic pain patients which necessitates the perpetual requirement of novel medication therapy. Therefore, this study explored the ameliorative aptitude of two novel methanimine imitative like (E)-N-(4-nitrobenzylidene)-4‑chloro-2-iodobenzamine (KB 09) and (E)-N-(4-methylbenzylidene)-4‑chloro-2-iodobenzamine (KB 10) in chronic constriction injury (CCI) of sciatic nerve induced neuropathic pain in rat model. Standard behavioral tests like dynamic and static allodynia, cold, thermal and mechanical hyperalgesia along with rotarod activity were performed at various experimental days like 0, 3, 7, 14 and 21. Enzyme linked immunosorbent assay (ELISA) on spinal tissue and antioxidant assays on sciatic nerve were executed accompanied by molecular docking and simulation studies. Prolonged ligation of sciatic nerve expressively induced hyperalgesia as well as allodynia in rats. KB 09 and KB 10 substantially attenuated the CCI elicited hyperalgesia and allodynia. They significantly reduced the biomarkers of pain and inflammation like Interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) in ELISA and while enhanced the GSH, SOD and CAT and diminished the MDA levels during antioxidant assays. KB 09 displayed -9.62 kcal/mol with TNF-α and -7.68 kcal/mol binding energy with IL-6 whereas KB 10 exhibited binding energy of -8.20 kcal/mol with IL-6 while -11.68 kcal/mol with TNF-α and hence both trial compounds ensured stable interaction with IL-6 and TNF-α during computational analysis. The results advocated that both methanimine derivatives might be novel candidates for attenuation of CCI-induced neuropathic pain prospects via anti-nociceptive, anti-inflammatory and antioxidant mechanisms.
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Affiliation(s)
- Jawad Khan
- Department of Pharmacy, University of Peshawar, Peshawar 25120, Pakistan.
| | - Gowhar Ali
- Department of Pharmacy, University of Peshawar, Peshawar 25120, Pakistan.
| | - Aamer Saeed
- Department of Chemistry, Quaid-I-Azam University Islamabad 45320, Pakistan
| | - Asma Khurshid
- Department of Chemistry, Quaid-I-Azam University Islamabad 45320, Pakistan.
| | - Sajjad Ahmad
- Department of Health and Biological Sciences, Abasyn University Peshawar 25000, Pakistan
| | - Hamdy Kashtoh
- Department of Biotechnology, Yeungnam University, Gyeongbuk, Korea.
| | - Farid S Ataya
- Department of Biochemistry, College of Science, King Saud University, PO Box 2455, Riyadh 11451, Saudi Arabia
| | - Gaber El-Saber Bathiha
- Department of Pharmacology and Therapeutics, Faculty of Veterinary Medicine, Damanhour University, Damanhour 22511, AlBeheria, Egypt
| | - Aman Ullah
- Department of Pharmacy, Saba Medical Center, Abu Dhabi PO Box 20316, United Arab Emirates
| | - Ajmal Khan
- Natural and Medical Sciences Research Center, University of Nizwa, P.O Box 33, Postal Code 616, Birkat Al Mauz, Nizwa, Sultanate of Oman
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Gao L, Zhang AP, Fu L, Li QW, Qin XM, Zhao J. Huangqin decoction attenuates spared nerve injury (SNI)-induced neuropathic pain by modulating microglial M1/M2 polarization partially mediated by intestinal nicotinamide metabolism. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2024; 129:155594. [PMID: 38614040 DOI: 10.1016/j.phymed.2024.155594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 03/13/2024] [Accepted: 04/05/2024] [Indexed: 04/15/2024]
Abstract
BACKGROUND The incidence of neuropathic pain is progressively increasing over time. The activation of M1-type microglia plays a crucial role in the initiation and progression of neuropathic pain. Huangqin Decoction (HQD) is traditionally used to alleviate dysentery and abdominal pain. However, it remains unclear whether HQD can effectively mitigate neuropathic pain and the underlying mechanisms. PURPOSE The present study aims to investigate the impact of HQD on neuropathic pain induced by spared nerve injury (SNI) in mice, and to elucidate whether the analgesic effect of HQD is associated with microglia polarization. METHODS The analgesic effect of HQD on SNI mice was investigated through assessments of mechanical pain threshold, thermal pain threshold, cold pain threshold, and motor ability. We elucidated the molecular mechanisms of HQD in alleviating SNI-induced neuropathic pain by focusing on microglia polarization and intestinal metabolite abnormalities. The expression levels of markers associated with microglia polarization (Iba-1, CD68, CD206, iNOS) was detected by immunofluorescence and Western blot, and the levels of inflammatory factors (IL-4, IL-10, IL-6, TNF-α) were assessed by ELISA. UPLC-QTOF-MS metabolomics was utilized to identify differential metabolites in the intestines of SNI mice. We screened the differential metabolites related to microglial polarization by correlation analysis, subsequently nicotinamide was selected for validation in LPS-induced BV-2 cells. RESULTS Our findings demonstrated that HQD (20 g/kg) significantly enhanced the mechanical pain threshold, thermal pain threshold, and cold pain threshold, and protected the injured DRG neurons of SNI mice. Moreover, HQD (20 g/kg) obviously suppressed the expression of microglia M1 polarization markers (Iba-1, CD68, iNOS, IL-6, TNF-α), and promoted the expression of microglia M2 polarization markers (CD206, IL-10, IL-4) in the spinal cord of SNI mice. Additionally, HQD (20 g/kg) prominently ameliorated intestinal barrier damage by upregulating Claudin 1 and Occludin expression in the colon of SNI mice. Furthermore, HQD (20 g/kg) rectified 19 metabolite abnormalities in the intestine. Notably, nicotinamide (100 μM), an amide derivative with anti-inflammatory property, effectively suppresses microglia activation and polarization in LPS-induced BV-2 cells by downregulating IL-6 level and CD68 expression while upregulating IL-4 level and CD206 expression. CONCLUSION In summary, HQD alleviates neuropathic pain in SNI mice by regulating the activation and polarization of microglia, partially mediated through intestinal nicotinamide metabolism.
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Affiliation(s)
- Li Gao
- Modern Research Center for Traditional Chinese Medicine, Shanxi University, Taiyuan, 030006, Shanxi, PR China; The Key Laboratory of Chemical Biology and Molecular Engineering of Ministry of Education, PR China; The Key Laboratory of Effective Substances Research and Utilization in TCM of Shanxi Province, PR China.
| | - Ai-Ping Zhang
- Modern Research Center for Traditional Chinese Medicine, Shanxi University, Taiyuan, 030006, Shanxi, PR China; The Key Laboratory of Chemical Biology and Molecular Engineering of Ministry of Education, PR China; The Key Laboratory of Effective Substances Research and Utilization in TCM of Shanxi Province, PR China
| | - Lei Fu
- Modern Research Center for Traditional Chinese Medicine, Shanxi University, Taiyuan, 030006, Shanxi, PR China; The Key Laboratory of Chemical Biology and Molecular Engineering of Ministry of Education, PR China; The Key Laboratory of Effective Substances Research and Utilization in TCM of Shanxi Province, PR China
| | - Qian-Wen Li
- Modern Research Center for Traditional Chinese Medicine, Shanxi University, Taiyuan, 030006, Shanxi, PR China; The Key Laboratory of Chemical Biology and Molecular Engineering of Ministry of Education, PR China; The Key Laboratory of Effective Substances Research and Utilization in TCM of Shanxi Province, PR China
| | - Xue-Mei Qin
- Modern Research Center for Traditional Chinese Medicine, Shanxi University, Taiyuan, 030006, Shanxi, PR China; The Key Laboratory of Chemical Biology and Molecular Engineering of Ministry of Education, PR China; The Key Laboratory of Effective Substances Research and Utilization in TCM of Shanxi Province, PR China
| | - Jing Zhao
- Wolfson Institute for Biomedical Research, University College London, UK, London.
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Upshaw WC, Soileau LG, Storey NR, Perkinson KA, Luther PM, Spillers NJ, Robinson CL, Miller BC, Ahmadzadeh S, Viswanath O, Shekoohi S, Kaye AD. An extract of phase II and III trials on recent developments in managing neuropathic pain syndromes: diabetic peripheral neuropathy, trigeminal neuralgia, and postherpetic neuralgia. Expert Opin Emerg Drugs 2024; 29:103-112. [PMID: 38410863 DOI: 10.1080/14728214.2024.2323193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 02/21/2024] [Indexed: 02/28/2024]
Abstract
INTRODUCTION Neuropathic pain (NP) conditions involve lesions to the somatosensory nervous system leading to chronic and debilitating pain. Many patients suffering from NP utilize pharmacological treatments with various drugs that seek to reduce pathologic neuronal states. However, many of these drugs show poor efficacy as well as cause significant adverse effects. Because of this, there is a major need for the development of safer and more efficacious drugs to treat NP. AREAS COVERED In this review, we analyzed current treatments being developed for a variety of NP conditions. Specifically, we sought drugs in phase II/III clinical trials with indications for NP conditions. Various databases were searched including Google Scholar, PubMed, and clinicaltrials.gov. EXPERT OPINION All the mentioned targets for treatments of NP seem to be promising alternatives for existing treatments that often possess poor side effect profiles for patients. However, gene therapy potentially offers the unique ability to inject a plasmid containing growth factors leading to nerve growth and repair. Because of this, gene therapy appears to be the most intriguing new treatment for NP.
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Affiliation(s)
- William C Upshaw
- School of Medicine, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA, USA
| | - Lenise G Soileau
- School of Medicine, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA, USA
| | - Nicholas R Storey
- School of Medicine, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA, USA
| | | | - Patrick M Luther
- School of Medicine, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA, USA
| | - Noah J Spillers
- School of Medicine, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA, USA
| | - Christopher L Robinson
- Beth Israel Deaconess Medical Center, Department of Anesthesiology, Critical Care, and Pain Medicine, Harvard Medical School, Boston, MA, USA
| | - Benjamin C Miller
- Department of Anesthesiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, USA
| | - Shahab Ahmadzadeh
- Department of Anesthesiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, USA
| | - Omar Viswanath
- Department of Anesthesiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, USA
- Creighton University School of Medicine, Phoenix, AZ, USA
| | - Sahar Shekoohi
- Department of Anesthesiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, USA
| | - Alan D Kaye
- Department of Anesthesiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, USA
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Wang Y, Zhang Y, Ma N, Zhao W, Ren X, Sun Y, Zang W, Cao J. SIRT1 mediates the excitability of spinal CaMKIIα-positive neurons and participates in neuropathic pain by controlling Nav1.3. CNS Neurosci Ther 2024; 30:e14764. [PMID: 38828629 PMCID: PMC11145124 DOI: 10.1111/cns.14764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 04/24/2024] [Accepted: 05/06/2024] [Indexed: 06/05/2024] Open
Abstract
AIMS Neuropathic pain is a common chronic pain disorder, which is largely attributed to spinal central sensitization. Calcium/calmodulin-dependent protein kinase II alpha (CaMKIIα) activation in the spinal dorsal horn (SDH) is a major contributor to spinal sensitization. However, the exact way that CaMKIIα-positive (CaMKIIα+) neurons in the SDH induce neuropathic pain is still unclear. This study aimed to explore the role of spinal CaMKIIα+ neurons in neuropathic pain caused by chronic constriction injury (CCI) and investigate the potential epigenetic mechanisms involved in CaMKIIα+ neuron activation. METHODS CCI-induced neuropathic pain mice model, Sirt1loxP/loxP mice, and chemogenetic virus were used to investigate whether the activation of spinal CaMKIIα+ neurons is involved in neuropathic pain and its involved mechanism. Transcriptome sequence, western blotting, qRT-PCR, and immunofluorescence analysis were performed to assay the expression of related molecules and activation of neurons. Co-immunoprecipitation was used to observe the binding relationship of protein. Chromatin immunoprecipitation (ChIP)-PCR was applied to analyze the acetylation of histone H3 in the Scn3a promoter region. RESULTS The expression of sodium channel Nav1.3 was increased and the expression of SIRT1 was decreased in the spinal CaMKIIα+ neurons of CCI mice. CaMKIIα neurons became overactive after CCI, and inhibiting their activation relieved CCI-induced pain. Overexpression of SIRT1 reversed the increase of Nav1.3 and alleviated pain, while knockdown of SIRT1 or overexpression of Nav1.3 promoted CaMKIIα+ neuron activation and induced pain. By knocking down spinal SIRT1, the acetylation of histone H3 in the Scn3a (encoding Nav1.3) promoter region was increased, leading to an increased expression of Nav1.3. CONCLUSION The findings suggest that an aberrant reduction of spinal SIRT1 after nerve injury epigenetically increases Nav1.3, subsequently activating CaMKIIα+ neurons and causing neuropathic pain.
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Affiliation(s)
- Yuanzeng Wang
- Department of Human Anatomy, School of Basic Medical SciencesZhengzhou UniversityZhengzhouHenanChina
- Neuroscience Research InstituteZhengzhou University Academy of Medical SciencesZhengzhouHenanChina
| | - Yidan Zhang
- Department of Human Anatomy, School of Basic Medical SciencesZhengzhou UniversityZhengzhouHenanChina
- Neuroscience Research InstituteZhengzhou University Academy of Medical SciencesZhengzhouHenanChina
| | - Nan Ma
- Department of Human Anatomy, School of Basic Medical SciencesZhengzhou UniversityZhengzhouHenanChina
- Neuroscience Research InstituteZhengzhou University Academy of Medical SciencesZhengzhouHenanChina
| | - Wen Zhao
- Department of Human Anatomy, School of Basic Medical SciencesZhengzhou UniversityZhengzhouHenanChina
- Neuroscience Research InstituteZhengzhou University Academy of Medical SciencesZhengzhouHenanChina
| | - Xiuhua Ren
- Department of Human Anatomy, School of Basic Medical SciencesZhengzhou UniversityZhengzhouHenanChina
| | - Yanyan Sun
- Department of Human Anatomy, School of Basic Medical SciencesZhengzhou UniversityZhengzhouHenanChina
| | - Weidong Zang
- Department of Human Anatomy, School of Basic Medical SciencesZhengzhou UniversityZhengzhouHenanChina
| | - Jing Cao
- Department of Human Anatomy, School of Basic Medical SciencesZhengzhou UniversityZhengzhouHenanChina
- The Nursing and Health SchoolZhengzhou UniversityZhengzhouHenanChina
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Cocoș DI, Dumitriu Buzia O, Tatu AL, Dinu M, Nwabudike LC, Stefan CS, Earar K, Galea C. Challenges in Optimizing Nanoplatforms Used for Local and Systemic Delivery in the Oral Cavity. Pharmaceutics 2024; 16:626. [PMID: 38794288 PMCID: PMC11124955 DOI: 10.3390/pharmaceutics16050626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 05/03/2024] [Accepted: 05/04/2024] [Indexed: 05/26/2024] Open
Abstract
In this study, we focused on innovative approaches to improve drug administration in oral pathology, especially by transmucosal and transdermal pathways. These improvements refer to the type of microneedles used (proposing needles in the saw), to the use of certain enhancers such as essential oils (which, besides the amplifier action, also have intrinsic actions on oral health), to associations of active substances with synergistic action, as well as the use of copolymeric membranes, cemented directly on the tooth. We also propose a review of the principles of release at the level of the oral mucosa and of the main release systems used in oral pathology. Controlled failure systems applicable in oral pathology include the following: fast dissolving films, mucoadhesive tablets, hydrogels, intraoral mucoadhesive films, composite wafers, and smart drugs. The novelty elements brought by this paper refer to the possibilities of optimizing the localized drug delivery system in osteoarthritis of the temporomandibular joint, neuropathic pain, oral cancer, periodontitis, and pericoronitis, as well as in maintaining oral health. We would like to mention the possibility of incorporating natural products into the controlled failure systems used in oral pathology, paying special attention to essential oils.
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Affiliation(s)
- Dorin Ioan Cocoș
- Centre in the Medical-Pharmaceutical Field, Faculty of Medicine and Pharmacy, “Dunarea de Jos” the University of Galati, 800008 Galati, Romania; (D.I.C.); (C.S.S.); (K.E.)
| | - Olimpia Dumitriu Buzia
- Centre in the Medical-Pharmaceutical Field, Faculty of Medicine and Pharmacy, “Dunarea de Jos” the University of Galati, 800008 Galati, Romania; (D.I.C.); (C.S.S.); (K.E.)
| | - Alin Laurențiu Tatu
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunarea de Jos” University, 800008 Galati, Romania;
- Dermatology Department, “Sf. Cuvioasa Parascheva” Clinical Hospital of Infectious Diseases, 800179 Galati, Romania
- Multidisciplinary Integrative Center for Dermatologic Interface Research MIC-DIR, 800010 Galati, Romania
| | - Monica Dinu
- Centre in the Medical-Pharmaceutical Field, Faculty of Medicine and Pharmacy, “Dunarea de Jos” the University of Galati, 800008 Galati, Romania; (D.I.C.); (C.S.S.); (K.E.)
| | | | - Claudia Simona Stefan
- Centre in the Medical-Pharmaceutical Field, Faculty of Medicine and Pharmacy, “Dunarea de Jos” the University of Galati, 800008 Galati, Romania; (D.I.C.); (C.S.S.); (K.E.)
| | - Kamel Earar
- Centre in the Medical-Pharmaceutical Field, Faculty of Medicine and Pharmacy, “Dunarea de Jos” the University of Galati, 800008 Galati, Romania; (D.I.C.); (C.S.S.); (K.E.)
| | - Carmen Galea
- Department of Medical Disciplines, Faculty of Dental Medicine, University of Targu Mures, 540099 Targu Mures, Romania;
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Reddy J, Singhal R, Gaikwad AP, Patel D, Patel P, Gandhi SK. Unraveling the Potential of Electroanalgesia: A Literature Review of Current Therapeutics. Cureus 2024; 16:e61122. [PMID: 38919207 PMCID: PMC11198869 DOI: 10.7759/cureus.61122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2024] [Indexed: 06/27/2024] Open
Abstract
Neuropathic pain (NP), arising from dysfunction in the neurological system, poses a significant challenge in pain management due to its intricate origin and unpredictable response to conventional treatments. Electroanalgesia, a collection of techniques such as transcutaneous electric nerve stimulation (TENS), peripheral electrical nerve stimulation (PENS), spinal cord stimulation (SCS), deep brain stimulation (DBS), and electroacupuncture (EA), presents a potential alternative or complementary approach. This review brings together evidence from 56 studies to evaluate the effectiveness and safety of electroanalgesia in chronic NP. It discusses the mechanisms underlying NP, the indications for electroanalgesia, and the techniques utilized, emphasizing the diverse applications and potential benefits. However, despite its potential uses, electroanalgesia has its limitations, including variable effectiveness and potential adverse effects. Furthermore, the review recognizes the limitations of the methodology and the need for further research to refine treatment protocols and enhance the understanding of electroanalgesia's role in comprehensive pain management strategies.
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Affiliation(s)
- Jyothsna Reddy
- Department of Internal Medicine, The Tamil Nadu Dr. M.G.R. (M.G.Ramachandran) Medical University, Chennai, IND
| | - Rohan Singhal
- Department of Internal Medicine, Atal Bihari Vajpayee Institute of Medical Sciences, New Delhi, IND
| | - Anand P Gaikwad
- Department of Internal Medicine, King Edward Memorial Hospital, Mumbai, IND
| | - Diya Patel
- Department of Internal Medicine, Gujarat Medical Education and Research Society, Sola, Ahmedabad, IND
| | - Priyansh Patel
- Department of Internal Medicine, Medical College Baroda, Vadodara, IND
| | - Siddharth Kamal Gandhi
- Department of Internal Medicine, Shri M.P. (Meghaji Pethraj) Shah Government Medical College, Jamnagar, IND
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Kim K, Nan G, Bak H, Kim HY, Kim J, Cha M, Lee BH. Insular cortex stimulation alleviates neuropathic pain through changes in the expression of collapsin response mediator protein 2 involved in synaptic plasticity. Neurobiol Dis 2024; 194:106466. [PMID: 38471625 DOI: 10.1016/j.nbd.2024.106466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 03/03/2024] [Accepted: 03/04/2024] [Indexed: 03/14/2024] Open
Abstract
In recent studies, brain stimulation has shown promising potential to alleviate chronic pain. Although studies have shown that stimulation of pain-related brain regions can induce pain-relieving effects, few studies have elucidated the mechanisms of brain stimulation in the insular cortex (IC). The present study was conducted to explore the changes in characteristic molecules involved in pain modulation mechanisms and to identify the changes in synaptic plasticity after IC stimulation (ICS). Following ICS, pain-relieving behaviors and changes in proteomics were explored. Neuronal activity in the IC after ICS was observed by optical imaging. Western blotting was used to validate the proteomics data and identify the changes in the expression of glutamatergic receptors associated with synaptic plasticity. Experimental results showed that ICS effectively relieved mechanical allodynia, and proteomics identified specific changes in collapsin response mediator protein 2 (CRMP2). Neuronal activity in the neuropathic rats was significantly decreased after ICS. Neuropathic rats showed increased expression levels of phosphorylated CRMP2, alpha amino-3-hydroxy-5-methylisoxazole-4-propionic acid receptor (AMPAR), and N-methyl-d-aspartate receptor (NMDAR) subunit 2B (NR2B), which were inhibited by ICS. These results indicate that ICS regulates the synaptic plasticity of ICS through pCRMP2, together with AMPAR and NR2B, to induce pain relief.
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Affiliation(s)
- Kyeongmin Kim
- Department of Physiology, Yonsei University College of Medicine, Seoul 03722, Republic of Korea; Department of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Guanghai Nan
- Department of Physiology, Yonsei University College of Medicine, Seoul 03722, Republic of Korea; Department of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Hyeji Bak
- Department of Physiology, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Hee Young Kim
- Department of Physiology, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Junesun Kim
- Rehabilitation Science Program, Department of Health Science, Graduate School, Korea University, Seoul 02841, Republic of Korea; Department of Health and Environment Science, College of Health Science, Korea University, Seoul 02841, Republic of Korea
| | - Myeounghoon Cha
- Department of Physiology, Yonsei University College of Medicine, Seoul 03722, Republic of Korea.
| | - Bae Hwan Lee
- Department of Physiology, Yonsei University College of Medicine, Seoul 03722, Republic of Korea; Department of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul 03722, Republic of Korea.
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Rusbridge C. Neuropathic pain in cats: Mechanisms and multimodal management. J Feline Med Surg 2024; 26:1098612X241246518. [PMID: 38710218 PMCID: PMC11156241 DOI: 10.1177/1098612x241246518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Abstract
PRACTICAL RELEVANCE Chronic pain is a significant welfare concern in cats, and neuropathic pain, which arises from aberrant processing of sensory signals within the nervous system, is a subcategory of this type of pain. To comprehend this condition and how multimodal pharmacotherapy plays a central role in alleviating discomfort, it is crucial to delve into the anatomy of nociception and pain perception. In addition, there is an intricate interplay between emotional health and chronic pain in cats, and understanding and addressing the emotional factors that contribute to pain perception, and vice versa, is essential for comprehensive care.Clinical approach:Neuropathic pain is suspected if there is abnormal sensation in the area of the distribution of pain, together with a positive response to trial treatment with drugs effective for neuropathic pain. Ideally, this clinical suspicion would be supported by confirmation of a lesion at this neurolocalisation using diagnostic modalities such as MRI and neuroelectrophysiology. Alternatively, there may be a history of known trauma at that site. A variety of therapies, including analgesic, anti-inflammatory and adjuvant drugs, and neuromodulation (eg, TENS or acupuncture), can be employed to address different facets of pain pathways.Aim:This review article, aimed at primary care/ general practitioners, focuses on the identification and management of neuropathic pain in cats. Three case vignettes are included and a structured treatment algorithm is presented to guide veterinarians in tailoring interventions.Evidence base:The review draws on current literature, where available, along with the author's extensive experience and research.
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Affiliation(s)
- Clare Rusbridge
- BVMS, PhD, DipECVN, FRCVS School of Veterinary Medicine, The University of Surrey, Guildford, Surrey, UK; and Wear Referrals Veterinary Specialist & Emergency Hospital, Bradbury, Stockton-on-Tees, UK
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Trivedi PD, Posani S, Balla N, Sheezan MM, Hussain AS, Xavier R, Popatbhai KM, Mateen MA, Prajjwal P, Marsool Marsool MD. Efficacy of pregabalin, amitriptyline, and gabapentin for neuropathic pain. Bioinformation 2024; 20:386-390. [PMID: 38854766 PMCID: PMC11161879 DOI: 10.6026/973206300200386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 04/30/2024] [Accepted: 04/30/2024] [Indexed: 06/11/2024] Open
Abstract
Neuropathic pain largely influences the well-being of patients. Anticonvulsant and antidepressant medications, such as Pregabalin, Gabapentin, and Amitriptyline, are routinely prescribed as initial treatments for neuropathic pain. The study sample has a total of 270 patients who meet the inclusion criteria and are further distributed into three equally sized groups (A, B, and C). Group A was administered with Gabapentine 300mg, Group B with Pregabalin 75 mg, and Amitriptyline 10 mg to Group C. The occurrence of any adverse drug response was documented using the ADR reporting form, while the pain of the patient's post-medication was recorded using a numerical pain rating scale (NPRS). The comparison of the NPRS scores of all three groups "by using ANOVA test" both at baseline and after 15 days reveal that the differences between the three groups are statistically insignificant (p > 0.089). However, after one month of continuous use, the difference becomes slightly significant (I.e., p = 0.003). Gabapentin, pregabalin, and amitriptyline demonstrate similar effectiveness in alleviating neuropathic (NeP) pain. The study concludes that gabapentin is superior to both pregabalin and amitriptyline with fewer adverse effects, leading to improved patient adherence for long-term use.
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Affiliation(s)
| | | | - Neeharika Balla
- Maharajah's Institute of Medical Sciences, Vizianagaram, India
| | | | | | - Roshni Xavier
- Medical Officer at Carewell Hospital, Padapparamba, Malappuram, Kerala , India
| | | | - Mohammed Abdul Mateen
- Shadan Institute of Medical Sciences Teaching hospital and Research Centre, Hyderabad, India
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Rodríguez-Palma EJ, Ramos-Rodríguez II, Huerta de la Cruz S, Granados-Soto V, Sancho M. Spinal nerve ligation: An experimental model to study neuropathic pain in rats and mice. Methods Cell Biol 2024; 188:73-88. [PMID: 38880529 DOI: 10.1016/bs.mcb.2024.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2024]
Abstract
Neuropathic pain, defined as the most terrible of all tortures, which a nerve wound may inflict, is a common chronic painful condition caused by gradual damage or dysfunction of the somatosensory nervous system. As with many chronic diseases, neuropathic pain has a profound economic and emotional impact worldwide and represents a major public health issue from a treatment standpoint. This condition involves multiple sensory symptoms including impaired transmission and perception of noxious stimuli, burning, shooting, spontaneous pain, mechanical or thermal allodynia and hyperalgesia. Current pharmacological options for the treatment of neuropathic pain are limited, ineffective and have unacceptable side effects. In this framework, a deeper understanding of the pathophysiology and molecular mechanisms associated with neuropathic pain is key to the development of promising new therapeutical approaches. For this purpose, a plethora of experimental models that mimic common clinical features of human neuropathic pain have been characterized in rodents, with the spinal nerve ligation (SNL) model being one of the most widely used. In this chapter, we provide a detailed surgical procedure of the SNL model used to induce neuropathic pain in rats and mice. We further describe the behavioral approaches used for stimulus-evoked and spontaneous pain assessment in rodents. Finally, we demonstrate that our SNL model induces multiple pain behaviors in rats and mice.
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Affiliation(s)
- Erick J Rodríguez-Palma
- Neurobiology of Pain Laboratory, Departamento de Farmacobiología, Cinvestav, South Campus, Mexico City, Mexico.
| | - Itzel I Ramos-Rodríguez
- Neurobiology of Pain Laboratory, Departamento de Farmacobiología, Cinvestav, South Campus, Mexico City, Mexico; División Académica de Ciencias de la Salud, Universidad Juárez Autónoma de Tabasco, Villahermosa, Mexico
| | | | - Vinicio Granados-Soto
- Neurobiology of Pain Laboratory, Departamento de Farmacobiología, Cinvestav, South Campus, Mexico City, Mexico
| | - Maria Sancho
- Department of Pharmacology, University of Vermont, Burlington, VT, United States; Department of Physiology, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain.
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Su Y, Verkhratsky A, Yi C. Targeting connexins: possible game changer in managing neuropathic pain? Trends Mol Med 2024:S1471-4914(24)00064-9. [PMID: 38594094 DOI: 10.1016/j.molmed.2024.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 03/08/2024] [Accepted: 03/18/2024] [Indexed: 04/11/2024]
Abstract
Neuropathic pain is a chronic debilitating condition caused by nerve injury or a variety of diseases. At the core of neuropathic pain lies the aberrant neuronal excitability in the peripheral and/or central nervous system (PNS and CNS). Enhanced connexin expression and abnormal activation of connexin-assembled gap junctional channels are prominent in neuropathic pain along with reactive gliosis, contributing to neuronal hypersensitivity and hyperexcitability. In this review, we delve into the current understanding of how connexin expression and function contribute to the pathogenesis and pathophysiology of neuropathic pain and argue for connexins as potential therapeutic targets for neuropathic pain management.
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Affiliation(s)
- Yixun Su
- Research Centre, Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
| | - Alexei Verkhratsky
- Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK; Achucarro Center for Neuroscience, IKERBASQUE, Bilbao, Spain; Department of Stem Cell Biology, State Research Institute Centre for Innovative Medicine, Vilnius, Lithuania; Department of Forensic Analytical Toxicology, School of Forensic Medicine, China Medical University, Shenyang, China.
| | - Chenju Yi
- Research Centre, Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China; Guangdong Provincial Key Laboratory of Brain Function and Disease, Guangzhou, China; Shenzhen Key Laboratory of Chinese Medicine Active substance screening and Translational Research, Shenzhen, China.
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Coelho DRA, Gersten M, Jimenez AS, Fregni F, Cassano P, Vieira WF. Treating neuropathic pain and comorbid affective disorders: Preclinical and clinical evidence. Pain Pract 2024. [PMID: 38572653 DOI: 10.1111/papr.13370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
INTRODUCTION Neuropathic pain (NP) significantly impacts quality of life and often coexists with affective disorders such as anxiety and depression. Addressing both NP and its psychiatric manifestations requires a comprehensive understanding of therapeutic options. This study aimed to review the main pharmacological and non-pharmacological treatments for NP and comorbid affective disorders to describe their mechanisms of action and how they are commonly used in clinical practice. METHODS A review was conducted across five electronic databases, focusing on pharmacological and non-pharmacological treatments for NP and its associated affective disorders. The following combination of MeSH and title/abstract keywords were used: "neuropathic pain," "affective disorders," "depression," "anxiety," "treatment," and "therapy." Both animal and human studies were included to discuss the underlying therapeutic mechanisms of these interventions. RESULTS Pharmacological interventions, including antidepressants, anticonvulsants, and opioids, modulate neural synaptic transmission to alleviate NP. Topical agents, such as capsaicin, lidocaine patches, and botulinum toxin A, offer localized relief by desensitizing pain pathways. Some of these drugs, especially antidepressants, also treat comorbid affective disorders. Non-pharmacological techniques, including repetitive transcranial magnetic stimulation, transcranial direct current stimulation, and photobiomodulation therapy, modulate cortical activity and have shown promise for NP and mood disorders. CONCLUSIONS The interconnection between NP and comorbid affective disorders necessitates holistic therapeutic strategies. Some pharmacological treatments can be used for both conditions, and non-pharmacological interventions have emerged as promising complementary approaches. Future research should explore novel molecular pathways to enhance treatment options for these interrelated conditions.
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Affiliation(s)
- David Richer Araujo Coelho
- Division of Neuropsychiatry and Neuromodulation, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
- Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Maia Gersten
- Division of Neuropsychiatry and Neuromodulation, Massachusetts General Hospital, Boston, Massachusetts, USA
| | | | - Felipe Fregni
- Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital, Boston, Massachusetts, USA
| | - Paolo Cassano
- Division of Neuropsychiatry and Neuromodulation, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Willians Fernando Vieira
- Division of Neuropsychiatry and Neuromodulation, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
- Department of Anatomy, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
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Hwang SM, Rahman MM, Go EJ, Kim YH, Park CK. Specific transcription factors Ascl1 and Lhx6 attenuate diabetic neuropathic pain by modulating spinal neuroinflammation and microglial activation in mice. Biomed Pharmacother 2024; 173:116392. [PMID: 38479183 DOI: 10.1016/j.biopha.2024.116392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 02/23/2024] [Accepted: 03/06/2024] [Indexed: 03/27/2024] Open
Abstract
Gamma-aminobutyric acid (GABA) neuronal system-related transcription factors (TFs) play a critical role in GABA production, and GABA modulates diabetic neuropathic pain (DNP). The present study investigated the therapeutic effects of intrathecal delivery of two TFs achaete-scute homolog 1 (Ascl1) and LIM homeobox protein 6 (Lhx6) in a mouse model of DNP and elucidated their underlying mechanisms. GABA-related specific TFs, including Ascl1, Lhx6, distal-less homeobox 1, distal-less homeobox 5, the Nkx2.1 homeobox gene, and the Nkx2.2 homeobox gene, were investigated under normal and diabetic conditions. Among these, the expression of Ascl1 and Lhx6 was significantly downregulated in mice with diabetes. Therefore, a single intrathecal injection of combined lenti-Ascl1/Lhx6 was performed. Intrathecal delivery of lenti-Ascl1/Lhx6 significantly relieved mechanical allodynia and heat hyperalgesia in mice with DNP. Ascl1/Lhx6 delivery also reduced microglial activation, decreased the levels of pro-inflammatory cytokines including tumor necrosis factor-α and interleukin (IL)-1β, increased the levels of anti-inflammatory cytokines including IL-4, IL-10, and IL-13, and reduced the activation of p38, c-Jun N-terminal kinase, and NF-κB in the spinal cord of mice with DNP, thereby reducing DNP. The results of this study suggest that intrathecal Ascl1/Lhx6 delivery attenuates DNP via upregulating spinal GABA neuronal function and inducing anti-inflammatory effects.
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Affiliation(s)
- Sung-Min Hwang
- Gachon Pain Center and Department of Physiology, Gachon University College of Medicine, Incheon 21999, Republic of Korea
| | - Md Mahbubur Rahman
- Gachon Pain Center and Department of Physiology, Gachon University College of Medicine, Incheon 21999, Republic of Korea
| | - Eun Jin Go
- Gachon Pain Center and Department of Physiology, Gachon University College of Medicine, Incheon 21999, Republic of Korea
| | - Yong Ho Kim
- Gachon Pain Center and Department of Physiology, Gachon University College of Medicine, Incheon 21999, Republic of Korea.
| | - Chul-Kyu Park
- Gachon Pain Center and Department of Physiology, Gachon University College of Medicine, Incheon 21999, Republic of Korea.
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Charlton E, Atkins KJ, Evered L, Silbert B, Scott DA. The long-term incidence of chronic post-surgical pain after coronary artery bypass surgery - A prospective observational study. Eur J Pain 2024; 28:599-607. [PMID: 37969009 DOI: 10.1002/ejp.2203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 10/17/2023] [Accepted: 11/03/2023] [Indexed: 11/17/2023]
Abstract
BACKGROUND Chronic post-surgical pain (CPSP) represents a significant issue for many patients following surgery; however, the long-term incidence and impact have not been well described following cardiac surgery. Our aim was to characterize CPSP at least 5 years following coronary artery bypass grafting (CABG) surgery. METHODS This prospective observational study investigated a cohort of patients from a larger trial investigating cognitive outcomes following CABG surgery, with 89 of 148 eligible patients (60.1%) assessed for CPSP at a mean (standard deviation [SD]) of 6.8 [1.2] years. Questionnaires interrogated pain presence, intensity, location, neuropathic characteristics, Geriatric Depression Scale scores (GDS) and instrumental activities of daily living (IADL). RESULTS CPSP was described in 21/89 (23.6%), with 10 rating it as moderate to severe. Six of the CPSP patients (29%) met criteria for neuropathic pain (6.7% overall). The highest rate of CPSP was associated with the leg surgical site (chest 12/89 [13.5%], arm 8/68 [11.8%] and leg (saphenous vein graft-SVG) 11/37 [29.7%]; χ2 = 6.523, p = 0.038). IADL scores were significantly lower for patients with CPSP (mean [SD]: 36.7 [1.6] vs. no CPSP 40.6 [0.6]; p = 0.006). Patients had GDS scores consistent with moderate depression (GDS >8) in 3/21 (14.3%) with CPSP, versus 3/68 (4.4%) non-CPSP patients (χ2 = 3.20, p = 0.073). CONCLUSIONS This study identified a CPSP incidence of 23.6% at a mean of 6.8 years after CABG surgery, with the highest pain proportion at SVG harvest sites. CPSP was associated with neuropathic pain symptoms and had a significant impact on IADLs. This emphasizes the need for long-term follow-up of CABG patients. SIGNIFICANCE This study highlights the impact of CPSP 7 years following cardiac surgery and highlights the effect of surgical site, neuropathic pain and the importance of including pain assessment and management in the long-term follow-up of cardiac surgical patients. Strategies to address and prevent chronic pain following cardiac surgery should be further explored.
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Affiliation(s)
- E Charlton
- Department of Anaesthesia and Acute Pain Medicine, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia
- Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia
| | - K J Atkins
- Department of Anaesthesia and Acute Pain Medicine, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia
- Department of Critical Care, Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia
- Department of Anesthesiology, Weill Cornell Medicine, New York, New York, USA
| | - L Evered
- Department of Anaesthesia and Acute Pain Medicine, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia
- Department of Critical Care, Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia
- Department of Anesthesiology, Weill Cornell Medicine, New York, New York, USA
| | - B Silbert
- Department of Anaesthesia and Acute Pain Medicine, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia
- Department of Critical Care, Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia
| | - D A Scott
- Department of Anaesthesia and Acute Pain Medicine, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia
- Department of Critical Care, Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia
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Chen SH, Lin YW, Tseng WL, Lin WT, Lin SC, Hsueh YY. Ultrahigh frequency transcutaneous electrical nerve stimulation for neuropathic pain alleviation and neuromodulation. Neurotherapeutics 2024; 21:e00336. [PMID: 38368171 PMCID: PMC10943071 DOI: 10.1016/j.neurot.2024.e00336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 02/04/2024] [Accepted: 02/06/2024] [Indexed: 02/19/2024] Open
Abstract
A challenging complication in patients with peripheral compressive neuropathy is neuropathic pain. Excessive neuroinflammation at the injury site worsens neuropathic pain and impairs function. Currently, non-invasive modulation techniques like transcutaneous electrical nerve stimulation (TENS) have shown therapeutic promise with positive results. However, the underlying regulatory molecular mechanism for pain relief remains complex and unexplored. This study aimed to validate the therapeutic effect of ultrahigh frequency (UHF)-TENS in chronic constriction injury of the rat sciatic nerve. Alleviation of mechanical allodynia was achieved through the application of UHF-TENS, lasting for 3 days after one session of therapy and 4 days after two sessions, without causing additional damage to the myelinated axon structure. The entire tissue collection schedule was divided into four time points: nerve exposure surgery, 7 days after nerve ligation, and 1 and 5 days after one session of UHF therapy. Significant reductions in pain-related neuropeptides, MEK, c-Myc, c-FOS, COX2, and substance P, were observed in the injured DRG neurons after UHF therapy. RNA sequencing of differential gene expression in sensory neurons revealed significant downregulation in Cables, Pik3r1, Vps4b, Tlr7, and Ezh2 after UHF therapy, while upregulation was observed in Nfkbie and Cln3. UHF-TENS effectively and safely relieved neuropathic pain without causing further nerve damage. The decreased production of pain-related neuropeptides within the DRG provided the therapeutic benefit. Possible molecular mechanisms behind UHF-TENS may result from the modulation of the NF-κB complex, toll-like receptor-7, and phosphoinositide 3-kinase/Akt signaling pathways. These results suggest the neuromodulatory effects of UHF-TENS in rat sciatic nerve chronic constriction injury, including alleviation of neuropathic pain, amelioration of pain-related neuropeptides, and regulation of neuroinflammatory gene expression. In combination with the regulation of related neuroinflammatory genes, UHF-TENS could become a new modality for enhancing the treatment of neuropathic pain in the future.
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Affiliation(s)
- Szu-Han Chen
- Division of Plastic and Reconstructive Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Center of Cell Therapy, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; International Research Center for Wound Repair and Regeneration, National Cheng Kung University, Tainan, Taiwan; Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yu-Wen Lin
- Division of Plastic and Reconstructive Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Wan-Ling Tseng
- Division of Plastic and Reconstructive Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Division of Plastic and Reconstructive Surgery, Department of Surgery, Tainan Hospital, Ministry of Health and Welfare, Tainan 700, Taiwan
| | - Wei-Tso Lin
- Gimer Medical Co., Ltd, New Taipei City, Taiwan
| | - Sheng-Che Lin
- Division of Plastic Surgery, Department of Surgery, An-Nan Hospital, China Medical University, Tainan, Taiwan
| | - Yuan-Yu Hsueh
- Division of Plastic and Reconstructive Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Center of Cell Therapy, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; International Research Center for Wound Repair and Regeneration, National Cheng Kung University, Tainan, Taiwan; Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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16
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de Liyis BG, Sutedja JC, Tjandra DC, Widha Putri NLPS, Gunawan MFB, Karuniamaya CP, Barus JFA, Pinzon RT, Widyadharma IPE. Serotonin norepinephrine reuptake inhibitors in managing neuropathic pain following spinal and non-spinal surgery: A systematic review and meta-analysis of randomized controlled trials. Clin Neurol Neurosurg 2024; 239:108223. [PMID: 38484604 DOI: 10.1016/j.clineuro.2024.108223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 02/19/2024] [Accepted: 03/01/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND While serotonin norepinephrine reuptake inhibitors (SNRIs) offer promise in managing Post-surgical neuropathic pain (PSNP), uncertainties remain. This study aims to evaluate the effectiveness and adverse events of SNRIs in managing PSNP. METHODS Systematic searches of PubMed, Embase, and Cochrane databases up to January 1st 2023 identified randomized controlled trials (RCTs) comparing SNRIs to placebo for PSNP. The primary outcome measures were pain at rest and adverse events post-surgery. Subgroup analyses were conducted based on surgical type and specific SNRIs. RESULTS A total of 19 RCTs, encompassing 1440 participants (719 in the SNRI group vs 721 in the placebo group), met the inclusion criteria and were included. The pooled results demonstrated that pain scores were significantly lower in patients treated with SNRIs at 2 hours (MD:-0.26; 95%CI: -0.47 to -0.04; p=0.02), 6 hours (MD:-0.68; 95%CI: -1.01 to -0.34; p<0.0001), 24 hours (MD:-0.54; 95%CI: -0.99 to -0.09; p=0.02), and 48 hours (MD:-0.66; 95%CI: -1.23 to -0.10; p=0.02) post-surgery. In terms of adverse events, dizziness (OR:2.53; 95%CI: 1.34-4.78; p=0.004) and dry mouth (OR:2.21; 95%CI: 1.25-3.92; p=0.007) were significantly higher in the SNRIs group. Subgroup analysis showed that SNRI was found to significantly lower the 24-hour pain score after spinal surgery (MD:-0.45; 95%CI: -0.84 to -0.05; p=0.03). Duloxetine (MD:-0.63; 95%CI: -1.15 to -0.11; p=0.02) had a significant effect in lowering the 24-hour pain score at rest compared to placebo, whereas venlafaxine did not. CONCLUSIONS SNRIs yielded considerable pain score reductions across multiple post-surgical intervals, although accompanied by an increased incidence of dizziness and dry mouth.
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Affiliation(s)
| | | | | | | | | | | | - Jimmy Fransisco Abadinta Barus
- Department of Neurology, School of Medicine and Health Science, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - Rizaldi Taslim Pinzon
- Department of Neurology, Duta Wacana University School of Medicine, Yogyakarta, Indonesia
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Lewis M, Baroutian S, Hanning SM. Phytocannabinoids for the Treatment of Neuropathic Pain: A Scoping Review of Randomised Controlled Trials Published Between 2012 and 2023. Curr Pain Headache Rep 2024; 28:109-118. [PMID: 38095748 DOI: 10.1007/s11916-023-01196-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2023] [Indexed: 03/10/2024]
Abstract
PURPOSE OF REVIEW Neuropathic pain (NP) remains a challenge to treat, with 50% of patients experiencing limited efficacy from current treatments. Medicinal cannabis, which contains tetrahydrocannabinol (THC), cannabidiol (CBD) and other minor cannabinoids, is garnering attention as an alternative treatment for NP. This paper reviews the clinical evidence for phytocannabinoid treatment of NP. RECENT FINDINGS Seventeen randomised controlled trials (RCT) were identified for inclusion in this review. Of these, ten studies using phytocannabinoid preparations containing THC alone had the most evidence for pain relief. Four studies investigating THC/CBD combinations showed some reductions in pain scores, although not all findings were statistically significant, whereas studies investigating CBD (two studies) or cannabidivarin (one study) showed no analgesic effect over placebo. However, CBD studies were of small sample size when compared to other studies in the review and short duration. Results for treatment of diabetic peripheral neuropathy patients with THC showed better improvements over those for NP induced by chemotherapy and multiple sclerosis, with these trials using vaporised whole plant cannabis. This formulation may have trace amounts of other minor cannabinoids, compared with synthetic cannabinoids such as dronabinol or nabilone that were investigated in other studies. This review provides an overview of RCTs that have investigated phytocannabinoid use for the treatment of NP. There appears to be evidence to necessitate further high quality RCTs into novel formulations of phytocannabinoids for the treatment of NP.
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Affiliation(s)
- Marc Lewis
- Department of Chemical and Materials Engineering, The University of Auckland, Auckland, 1010, New Zealand
| | - Saeid Baroutian
- Department of Chemical and Materials Engineering, The University of Auckland, Auckland, 1010, New Zealand
- Circular Innovations (CIRCUIT) Research Centre, The University of Auckland, Auckland, 1010, New Zealand
- Ngā Ara Whetū Centre for Climate, Biodiversity and Society, The University of Auckland, Auckland, 1010, New Zealand
| | - Sara M Hanning
- School of Pharmacy, The University of Auckland, Auckland, 1010, New Zealand.
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Pereira WF, Everson da Silva L, do Amaral W, Andrade Rebelo R, Quefi B, Wlisses da Silva A, Silva Marinho E, Borges Leal ALA, Mesquita Cajazeiras FF, Amâncio Ferreira MK, Bezerra Maciel J, Ribeiro Liberato H, Guedes JM, Silva Alencar de Menezes JE, Teixeira AMR, Silva Dos Santosa H. Essential Oils from the Genus Piper Promote Antinociception by Modulating TRP Channels and Anti-Inflammatory Effects in Adult Zebrafish. Chem Biodivers 2024; 21:e202301807. [PMID: 38284478 DOI: 10.1002/cbdv.202301807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 01/25/2024] [Accepted: 01/29/2024] [Indexed: 01/30/2024]
Abstract
The Piper genus, known for its pharmacological potential, comprises 2,263 species primarily found in tropical regions. Despite recent advancements in pain therapies, the demand for more effective and well-tolerated analgesics and anti-inflammatories, particularly for chronic pain, remains. This study assessed the effects of essential oils from Piper caldense, Piper mosenii, and Piper mikanianum on nociceptive behavior induced by formalin and capsaicin, as well as their anti-inflammatory impact induced by carrageenan, using adult zebrafish models. Results indicated non-toxic essential oils with antinociceptive properties in both neurogenic and inflammatory phases of formalin-induced nociception through interaction with the TRPA1 receptor. Additionally, P. mosenii essential oil also blocked the nociceptive effect of capsaicin, a TRPV1 receptor agonist. Furthermore, essential oils from P. caldense and P. mikanianum exhibited significant anti-inflammatory effects by reducing carrageenan-induced abdominal edema. These findings highlight the pharmacological potential of Piper's essential oils as antinociceptive and anti-inflammatory agents.
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Affiliation(s)
| | - Luiz Everson da Silva
- Postgraduate Program in Sustainable Territorial Development, Federal University of Paraná, Matinhos, PR, Brazil
| | - Wanderlei do Amaral
- Department of Chemical Engineering, Federal University of Parana, Curitiba, Parana, Brazil
| | - Ricardo Andrade Rebelo
- Department of Chemistry, Regional University of Blumenau (FURB), Itoupava Seca, Blumenau, SC, Brazil
| | - Blasco Quefi
- Department of Chemistry, Regional University of Blumenau (FURB), Itoupava Seca, Blumenau, SC, Brazil
| | - Antonio Wlisses da Silva
- Postgraduate Program in Biotechnology - RENORBIO, State University of Ceará, Fortaleza, CE, Brazil
| | - Emmanuel Silva Marinho
- Postgraduate Program in Natural Sciences, State University of Ceara, Fortaleza, CE, Brazil
| | | | | | | | - Jéssica Bezerra Maciel
- Postgraduate Program in Natural Sciences, State University of Ceara, Fortaleza, CE, Brazil
| | | | - Jesyka Macêdo Guedes
- Postgraduate Program in Natural Sciences, State University of Ceara, Fortaleza, CE, Brazil
| | | | - Alexandre Magno Rodrigues Teixeira
- Postgraduate Program in Biotechnology - RENORBIO, State University of Ceará, Fortaleza, CE, Brazil
- Postgraduate Program in Natural Sciences, State University of Ceara, Fortaleza, CE, Brazil
| | - Helcio Silva Dos Santosa
- Postgraduate Program in Biotechnology - RENORBIO, State University of Ceará, Fortaleza, CE, Brazil
- Postgraduate Program in Natural Sciences, State University of Ceara, Fortaleza, CE, Brazil
- Chemistry Course, State University of Vale do Acaraú, Sobral, CE, Brazil
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Guo N, Raincrow J, Chiu CH, Yu L. Phylogenetic analysis of mammalian SIP30 sequences indicating accelerated adaptation of functional domain in primates. Biochem Biophys Rep 2024; 37:101631. [PMID: 38188366 PMCID: PMC10771893 DOI: 10.1016/j.bbrep.2023.101631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 12/21/2023] [Accepted: 12/27/2023] [Indexed: 01/09/2024] Open
Abstract
SIP30, characterized by a coiled-coil functional domain, plays a key role in regulating synaptic vesicle exocytosis and is implicated in neuropathic pain resulting from peripheral nerve injury. Because neuropathic pain is studied in primates (including human), domesticated animals, and rodents, we conducted a phylogenetic analysis of SIP30 in selected species of these three groups of mammals. SIP30 exhibits a high degree of sequence divergence in comparison to its protein binding partners SNAP25 and ZW10, which show broad sequence conservation. Notably, we observed an increased rate of change in the highly conserved coiled-coil domain in the SIP30 protein, specifically within primates. This observation suggests an accelerated adaptation of this functional domain in primate species.
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Affiliation(s)
- Ning Guo
- Department of Genetics, Rutgers University, Piscataway, NJ, 08854, USA
| | - Jeremy Raincrow
- Department of Genetics, Rutgers University, Piscataway, NJ, 08854, USA
| | - Chi-hua Chiu
- Department of Genetics, Rutgers University, Piscataway, NJ, 08854, USA
- School of Biomedical Sciences, and Department of Biological Sciences, Kent State University, Kent, Ohio, 44242, USA
| | - Lei Yu
- Department of Genetics, Rutgers University, Piscataway, NJ, 08854, USA
- Center of Alcohol & Substance Use Studies, Rutgers University, Piscataway, NJ, 08854, USA
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Park M, Koh CS, Chang H, Kim TJ, Mun W, Chang JW, Jung HH. Low-frequency (5-Hz) stimulation of ventrolateral periaqueductal gray modulates the descending serotonergic system in the peripheral neuropathic pain. Pain 2024:00006396-990000000-00536. [PMID: 38422490 DOI: 10.1097/j.pain.0000000000003185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 11/15/2023] [Indexed: 03/02/2024]
Abstract
ABSTRACT Neuropathic pain is a type of chronic pain that entails severe prolonged sensory dysfunctions caused by a lesion of the somatosensory system. Many of those suffering from the condition do not experience significant improvement with existing medications, resulting in various side effects. In this study, Sprague-Dawley male rats were used, and long-term deep brain stimulation of the ventrolateral periaqueductal gray was conducted in a rat model of spared nerve injury. We found that 5-Hz deep brain stimulation effectively modulated mechanical allodynia and induced neuronal activation in the rostral ventromedial medulla, restoring impaired descending serotonergic system. At the spinal level, glial cells were still activated but only the 5-HT1a receptor in the spinal cord was activated, implying its inhibitory role in mechanical allodynia. This study found that peripheral neuropathy caused dysfunction in the descending serotonergic system, and prolonged stimulation of ventrolateral periaqueductal gray can modulate the pathway in an efficient manner. This work would provide new opportunities for the development of targeted and effective treatments for this debilitating disease, possibly giving us lower chances of side effects from repeated high-frequency stimulation or long-term use of medication.
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Affiliation(s)
- Minkyung Park
- Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Republic of Korea
- Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Chin Su Koh
- Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Heesue Chang
- Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Tae Jun Kim
- Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Wonki Mun
- Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jin Woo Chang
- Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Republic of Korea
- Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hyun Ho Jung
- Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Republic of Korea
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21
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Chen R, Xu X, Yu Y, Chen Y, Lin C, Liu R. High-voltage pulsed radiofrequency improves ultrastructure of DRG and enhances spinal microglial autophagy to ameliorate neuropathic pain induced by SNI. Sci Rep 2024; 14:4497. [PMID: 38402335 PMCID: PMC10894304 DOI: 10.1038/s41598-024-55095-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 02/20/2024] [Indexed: 02/26/2024] Open
Abstract
Neuropathic pain (NeP) is intractable for which many therapies are ineffective. High-voltage pulsed radiofrequency (HVPRF) on dorsal root ganglion (DRG) is considered an effective treatment for NeP. The aim of this study is to explore the therapeutic voltage for the optimal efficacy of PRF and the underlying mechanisms. The radiofrequency electrode was placed close to the L5 DRG of rats with spared nerve injury (SNI) and emitted current by the corresponding voltage in different groups. Four different voltages (45 V, 65 V, 85 V, and 100 V) of PRF on DRG significantly alleviated the SNI-induced NeP, reduced the levels of activating transcription factor 3 (ATF3) in DRG, improved the ultrastructure of DRG, and promoted autophagy in spinal microglia to varying degrees and partially reversed the increased expression of TNF-α and the reduced expression of IL-10 in spinal cord dorsal horn (SCDH). The beneficial effect of 85V-PRF was superior to those of other three PRF treatments. The underlying mechanisms may be related to repairing the DRG damage and improving the DRG ultrastructure while regulating spinal microglial autophagy and thereby alleviating neuroinflammation.
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Affiliation(s)
- Ri Chen
- Department of Pain Management, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, China
| | - Xueru Xu
- Department of Pain Management, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, China
| | - Youfen Yu
- Department of Pain Management, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, China
| | - Yanqin Chen
- Department of Anesthesiology, Women's and Children's Hospital of Xiamen University, Xiamen, China
| | - Chun Lin
- School of Basic Medical Sciences, Institute of Pain Research, Fujian Medical University, Fuzhou, Fujian, China
| | - Rongguo Liu
- Department of Pain Management, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, China.
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22
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Sharav Y, Heiliczer S, Benoliel R, Haviv Y. Pharmacological Topical Therapy for Intra-Oral Post Traumatic Trigeminal Neuropathic Pain: A Comprehensive Review. Pharmaceuticals (Basel) 2024; 17:264. [PMID: 38399479 PMCID: PMC10893422 DOI: 10.3390/ph17020264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 02/13/2024] [Accepted: 02/17/2024] [Indexed: 02/25/2024] Open
Abstract
Background: The efficacy of topical treatments in alleviating neuropathic pain is well-established. However, there is a paucity of research on topical interventions designed specifically for intra-oral application, where the tissue composition differs from that of exposed skin. Methods: This comprehensive review endeavors to assess the extant evidence regarding the efficacy of topical treatments in addressing neuropathic pain within the oral cavity. Utilizing combinations of search terms, we conducted a thorough search across standard electronic bibliographic databases-MEDLINE (via PubMed), Embase, Google Scholar, and Up to Date. The variables under scrutiny encompassed topical treatment, local intervention, chronic oral and orofacial pain, and neuropathic pain. All pertinent studies published in the English language between 1992 and 2022 were included in our analysis. Results: Fourteen relevant manuscripts were identified, primarily consisting of expert opinions and case reports. The comprehensive review suggests that topical treatments, especially when applied under a stent, could be effective in mitigating neuropathic pain in the oral area. However, it is crucial to conduct further studies to confirm these preliminary results. The limitations of the reviewed studies, mainly the reliance on expert opinions, small sample sizes, inconsistent study designs, and a lack of long-term follow-up data, highlight the need for more rigorous research. Conclusions: Although initial findings indicate topical treatments may be effective for oral neuropathic pain, the limitations of current studies call for more thorough research. Further comprehensive studies are essential to validate the efficacy of these treatments, standardize procedures, and determine long-term results. This will provide clearer guidance for treating chronic neuropathic pain in the oral cavity.
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Affiliation(s)
- Yair Sharav
- Department of Oral Medicine, Sedation and Imaging, Hadassah Medical Center, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel; (Y.S.); (S.H.)
| | - Shimrit Heiliczer
- Department of Oral Medicine, Sedation and Imaging, Hadassah Medical Center, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel; (Y.S.); (S.H.)
- Oral Medicine Unit, Oral and Maxillofacial Surgery Department, Tel Aviv Sourasky Medical Center, Tel Aviv 64239, Israel
| | | | - Yaron Haviv
- Department of Oral Medicine, Sedation and Imaging, Hadassah Medical Center, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel; (Y.S.); (S.H.)
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23
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Karimi SA, Zahra FT, Martin LJ. IUPHAR review: Navigating the role of preclinical models in pain research. Pharmacol Res 2024; 200:107073. [PMID: 38232910 DOI: 10.1016/j.phrs.2024.107073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 01/09/2024] [Accepted: 01/11/2024] [Indexed: 01/19/2024]
Abstract
Chronic pain is a complex and challenging medical condition that affects millions of people worldwide. Understanding the underlying mechanisms of chronic pain is a key goal of preclinical pain research so that more effective treatment strategies can be developed. In this review, we explore nociception, pain, and the multifaceted factors that lead to chronic pain by focusing on preclinical models. We provide a detailed look into inflammatory and neuropathic pain models and discuss the most used animal models for studying the mechanisms behind these conditions. Additionally, we emphasize the vital role of these preclinical models in developing new pain-relief drugs, focusing on biologics and the therapeutic potential of NMDA and cannabinoid receptor antagonists. We also discuss the challenges of TRPV1 modulation for pain treatment, the clinical failures of neurokinin (NK)- 1 receptor antagonists, and the partial success story of Ziconotide to provide valuable lessons for preclinical pain models. Finally, we highlight the overall success and limitations of current treatments for chronic pain while providing critical insights into the development of more effective therapies to alleviate the burden of chronic pain.
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Affiliation(s)
- Seyed Asaad Karimi
- Department of Psychology, University of Toronto Mississauga, Mississauga, ON L5L 1C6, Canada
| | - Fatama Tuz Zahra
- Department of Cell and Systems Biology, University of Toronto, Toronto, ON M5S 3G5, Canada
| | - Loren J Martin
- Department of Psychology, University of Toronto Mississauga, Mississauga, ON L5L 1C6, Canada; Department of Cell and Systems Biology, University of Toronto, Toronto, ON M5S 3G5, Canada.
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24
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Shekhar A, Srivastava A, Verma N, Verma A, Chaturvedi TP. The Comparative Efficacy of Palmitoylethanolamide (PEA) With the Combination of Pregabalin and Nortriptyline on Post-extraction Trigeminal Neuropathy by Using Magnetic Resonance (MR) Neurography: A Randomized Clinical Trial. Cureus 2024; 16:e54843. [PMID: 38533175 PMCID: PMC10963896 DOI: 10.7759/cureus.54843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2024] [Indexed: 03/28/2024] Open
Abstract
Aim The aim of this randomized clinical trial is to compare the efficacy of palmitoylethanolamide (PEA) with the combination of pregabalin and nortriptyline in treating post-extraction trigeminal neuropathy using magnetic resonance neurography (MRN). Methods The present prospective, randomized controlled trial was conducted on 60 patients (20 in each group). In group I (positive control group), a combination of 75 mg of pregabalin and 10 mg of nortriptyline was administered once daily for the duration of 12 weeks. In group II, 600 mg of palmitoylethanolamide was given twice a day. In group III, a combination therapy of the abovementioned drugs was given. The efficacy of the drug was assessed by measuring pain intensity in terms of the numeric rating scale (NRS) (primary outcome) and changes (signal intensity and nerve thickness) in magnetic resonance neurography (secondary outcome) at various intervals of time. The data was collected and subjected to statistical analysis using the Statistical Package for Social Sciences (SPSS) version 25 (IBM SPSS Statistics, Armonk, NY) at the significance level of P<0.05. Results A significant decrease in post-drug mean NRS scores was observed in all three groups. In terms of reduction in the mean NRS, the combination group showed the highest reduction. Palmitoylethanolamide significantly reduces pain scores with negligible side effects. Conclusion Palmitoylethanolamide helps in the reduction of mild to moderate pain of painful post-traumatic trigeminal neuropathy (PTTN) with minimal side effects, suggesting that it may be used where the use of the conventional drug is either contraindicated or not feasible.
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Affiliation(s)
- Amlendu Shekhar
- Department of Oral Medicine and Radiology, Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University (BHU), Varanasi, IND
| | - Adit Srivastava
- Department of Oral Medicine and Radiology, Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University (BHU), Varanasi, IND
| | - Nimisha Verma
- Department of Anesthesiology, Institute of Medical Sciences, Banaras Hindu University (BHU), Varanasi, IND
| | - Ashish Verma
- Department of Radiology, Institute of Medical Sciences, Banaras Hindu University (BHU), Varanasi, IND
| | - T P Chaturvedi
- Department of Orthodontics, Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University (BHU), Varanasi, IND
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25
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Leonardi A, Feuerman OM, Salami E, Lazzarini D, Cavarzeran F, Freo U, Maggioni F. Coexistence of neuropathic corneal pain, corneal nerve abnormalities, depression, and low quality of life. Eye (Lond) 2024; 38:499-506. [PMID: 37620513 PMCID: PMC10858266 DOI: 10.1038/s41433-023-02710-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 07/26/2023] [Accepted: 08/10/2023] [Indexed: 08/26/2023] Open
Abstract
PURPOSE To evaluate the quality of life (QoL), mental health conditions and corneal morphology in neuropathic corneal pain (NCP) subjects without a significant ocular surface disease. METHODS A composite questionnaire was administered to 228 consecutive subjects, assessing the pain intensity, duration, and quality using a modified version of the Self-Administered Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) and Pain Detect (PD) questionnaires. Subjects diagnosed with possible central NCP and two sub-groups of patients diagnosed with peripheral ocular pain completed an additional battery of mental health questionnaires and were examined by In Vivo Confocal Microscopy (IVCM). RESULTS Of the 76 subjects that reported chronic ocular pain (duration >1 month), 53 were classified with probable NCP. Nine subjects without signs that justify the pain and non-responding to topical anaesthesia, were considered affected by central NCP. In these patients, a significant negative correlation was found between the presence pain and the mental component of the QoL (R2 = 0.733), and a positive correlation between the severity of pain the presence post-traumatic stress disorder (R2 = 0.83) and depression (R2 = 0.93). Although neuromas and sprouting had higher frequency in the central NCP group compared the control groups, these differences was not statistically different. CONCLUSIONS The assessment of ocular pain characteristics using multiple questionnaires and IVCM may help to recognize differences between nociceptive and neuropathic pain. An association between pain intensity and mental health condition may guide the therapeutical choices.
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Affiliation(s)
- Andrea Leonardi
- Department of Neurosciences, Ophthalmology Unit, University of Padua, Padua, Italy.
| | - Oren Mark Feuerman
- Department of Neurosciences, Ophthalmology Unit, University of Padua, Padua, Italy
| | - Elena Salami
- Department of Neurosciences, Ophthalmology Unit, University of Padua, Padua, Italy
| | - Daniela Lazzarini
- Department of Neurosciences, Ophthalmology Unit, University of Padua, Padua, Italy
| | - Fabiano Cavarzeran
- Department of Neurosciences, Ophthalmology Unit, University of Padua, Padua, Italy
| | - Ulderico Freo
- Anesthesiology and Intensive Medicine, Department of Medicine - DIMED, University of Padua, Padua, Italy
| | - Ferdinando Maggioni
- Department of Neurosciences, Headache Centre, University of Padua, Padua, Italy
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26
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Fatima K, Javed SO, Saleem A, Marsia S, Zafar R, Noorani K, Kumar S, Ali SM, Ismail I, Hashim I, Ganatra FA. Long-term efficacy of spinal cord stimulation for chronic primary neuropathic pain in the contemporary era: a systematic review and meta-analysis. J Neurosurg Sci 2024; 68:128-139. [PMID: 36943763 DOI: 10.23736/s0390-5616.23.05930-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
INTRODUCTION Spinal cord stimulation (SCS) is a modern neuromodulation technique extensively proven to be an effective modality for treatment of chronic neuropathic pain. It has been mainly studied for complex regional pain syndrome (CRPS) and failed back surgery syndrome (FBSS) and recent data almost uniformly establishes its statistically significant positive therapeutic results. It has also been compared with other available treatment modalities across various studies. However, long term data on maintenance of its efficacious potential remains less explored. Few studies have reported data on long follow-up times (>= 12 months) and have compared its efficacy with other treatment options for chronic pain, respectively. Our study pools and analyzes the available data and compares SCS with other treatment options. It also analyzes the efficacy of SCS in long term management of patients with chronic pain. EVIDENCE ACQUISITION We reviewed all the data available on MEDLINE, Embase and Cochrane CENTRAL using a search strategy designed to fit our pre-set inclusion and exclusion criteria. Both single-arm and double-arm studies were included. The primary outcome was defined as decrease of visual analogue scale (VAS) by >50% at 6, 12 and/or 24 months after SCS. EVIDENCE SYNTHESIS According to the pooled data of double-arm studies, SCS has unanimously proven its superiority over other treatment options at 6 months follow-up; however it fails to prove statistically significant difference in results at longer treatment intervals. Dorsal root ganglion stimulation, a relatively recent technique with the same underlying physiologic mechanisms as SCS, showed far more promising results than SCS. Single-arm studies show around 70% patients experiencing greater than 50% reduction in their VAS scores at 6 and 12 months. CONCLUSIONS SCS is a viable option for management of chronic neuropathic pain secondary to FBSS and CRPS. However, data available for its long term efficacy remains scarce and show no further statistically significant results.
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Affiliation(s)
- Kaneez Fatima
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Syed O Javed
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Aqsa Saleem
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Shayan Marsia
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Ramsha Zafar
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Komal Noorani
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Sahlish Kumar
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan -
| | - Sara M Ali
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Iqra Ismail
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Insiya Hashim
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Fatima A Ganatra
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
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Zhang C, Li Y, Yu Y, Li Z, Xu X, Talifu Z, Liu W, Yang D, Gao F, Wei S, Zhang L, Gong H, Peng R, Du L, Li J. Impact of inflammation and Treg cell regulation on neuropathic pain in spinal cord injury: mechanisms and therapeutic prospects. Front Immunol 2024; 15:1334828. [PMID: 38348031 PMCID: PMC10859493 DOI: 10.3389/fimmu.2024.1334828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 01/03/2024] [Indexed: 02/15/2024] Open
Abstract
Spinal cord injury is a severe neurological trauma that can frequently lead to neuropathic pain. During the initial stages following spinal cord injury, inflammation plays a critical role; however, excessive inflammation can exacerbate pain. Regulatory T cells (Treg cells) have a crucial function in regulating inflammation and alleviating neuropathic pain. Treg cells release suppressor cytokines and modulate the function of other immune cells to suppress the inflammatory response. Simultaneously, inflammation impedes Treg cell activity, further intensifying neuropathic pain. Therefore, suppressing the inflammatory response while enhancing Treg cell regulatory function may provide novel therapeutic avenues for treating neuropathic pain resulting from spinal cord injury. This review comprehensively describes the mechanisms underlying the inflammatory response and Treg cell regulation subsequent to spinal cord injury, with a specific focus on exploring the potential mechanisms through which Treg cells regulate neuropathic pain following spinal cord injury. The insights gained from this review aim to provide new concepts and a rationale for the therapeutic prospects and direction of cell therapy in spinal cord injury-related conditions.
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Affiliation(s)
- Chunjia Zhang
- School of Rehabilitation, Capital Medical University, Beijing, China
- Department of Spinal and Neural Functional Reconstruction, China Rehabilitation Research Center, Beijing, China
| | - Yan Li
- Institute of Rehabilitation medicine, China Rehabilitation Research Center, Beijing, China
| | - Yan Yu
- Institute of Rehabilitation medicine, China Rehabilitation Research Center, Beijing, China
| | - Zehui Li
- School of Rehabilitation, Capital Medical University, Beijing, China
- Department of Spinal and Neural Functional Reconstruction, China Rehabilitation Research Center, Beijing, China
| | - Xin Xu
- School of Rehabilitation, Capital Medical University, Beijing, China
- Department of Spinal and Neural Functional Reconstruction, China Rehabilitation Research Center, Beijing, China
| | - Zuliyaer Talifu
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, China
| | - Wubo Liu
- School of Rehabilitation, Capital Medical University, Beijing, China
- Department of Spinal and Neural Functional Reconstruction, China Rehabilitation Research Center, Beijing, China
- Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Degang Yang
- School of Rehabilitation, Capital Medical University, Beijing, China
- Department of Spinal and Neural Functional Reconstruction, China Rehabilitation Research Center, Beijing, China
| | - Feng Gao
- School of Rehabilitation, Capital Medical University, Beijing, China
- Department of Spinal and Neural Functional Reconstruction, China Rehabilitation Research Center, Beijing, China
| | - Song Wei
- School of Rehabilitation, Capital Medical University, Beijing, China
- Department of Spinal and Neural Functional Reconstruction, China Rehabilitation Research Center, Beijing, China
| | - Liang Zhang
- School of Rehabilitation, Capital Medical University, Beijing, China
- Department of Spinal and Neural Functional Reconstruction, China Rehabilitation Research Center, Beijing, China
| | - Han Gong
- School of Rehabilitation, Capital Medical University, Beijing, China
- Department of Spinal and Neural Functional Reconstruction, China Rehabilitation Research Center, Beijing, China
| | - Run Peng
- School of Rehabilitation, Capital Medical University, Beijing, China
- Department of Spinal and Neural Functional Reconstruction, China Rehabilitation Research Center, Beijing, China
| | - Liangjie Du
- School of Rehabilitation, Capital Medical University, Beijing, China
- Department of Spinal and Neural Functional Reconstruction, China Rehabilitation Research Center, Beijing, China
| | - Jianjun Li
- School of Rehabilitation, Capital Medical University, Beijing, China
- Department of Spinal and Neural Functional Reconstruction, China Rehabilitation Research Center, Beijing, China
- Institute of Rehabilitation medicine, China Rehabilitation Research Center, Beijing, China
- Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
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28
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Xie W, Hou J, Li C, Zhang Q. Sodium aescinate ameliorates chronic neuropathic pain in male mice via suppressing JNK/p38-mediated microglia activation. Brain Inj 2024; 38:126-135. [PMID: 38324656 DOI: 10.1080/02699052.2024.2307966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 01/17/2024] [Indexed: 02/09/2024]
Abstract
OBJECTIVE A study confirmed that sodium aescinate (SA) can effectively relieve bone cancer pain, but its role in neuropathic pain (NP) remains confused. METHODS Eighty male mice were randomly divided into four groups: sham+vehicle, sham+SA (40 μg/L, intrathecal injection), chronic contraction injury (CCI)+vehicle, CCI+SA. Behavioral assessments were used to evaluate the locomotor activity and paw withdrawal threshold (PWT) of mice. At the end of the study, spinal cord tissues were collected for histopathological analysis. The JNK/p38 signaling activation, Iba-1 expression, pro-inflammatory cytokines levels, and microglia subtype were assessed by western blotting, immunohistochemical staining, enzyme-linked immunosorbent assay, and flow cytometry with CD86/CD206, respectively. RESULTS Early treatment with SA delayed the development of mechanical allodynia in CCI mice. Repeated SA treatment could prominently increase the reduction of PWT induced by CCI, and improve the locomotor activity of CCI mice. Mechanically, CCI surgery induced significant up-regulation of p-JNK and p-p38 protein levels, increased number and M1/M2 ratio of microglia, as well as pro-inflammatory factors in the spinal cords of mice, which could be blocked after SA administration. CONCLUSIONS SA might suppress the activation of microglia and neuroinflammation by selectively inhibiting the JNK/p38 signaling pathway, thereby alleviating CCI-induced NP in male mice.
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Affiliation(s)
- Wenqiang Xie
- Department of Anesthesiology, Yue Bei People's Hospital, Shaoguan, Guangdong, China
| | - Jie Hou
- Department of Quality Management, Yue Bei People's Hospital, Shaoguan, Guangdong, China
| | - Changke Li
- Department of Anesthesiology, Yue Bei People's Hospital, Shaoguan, Guangdong, China
| | - Qiang Zhang
- Department of Anesthesiology, Yue Bei People's Hospital, Shaoguan, Guangdong, China
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29
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Krishnan MA, Alimi OA, Pan T, Kuss M, Korade Z, Hu G, Liu B, Duan B. Engineering Neurotoxin-Functionalized Exosomes for Targeted Delivery to the Peripheral Nervous System. Pharmaceutics 2024; 16:102. [PMID: 38258111 PMCID: PMC10818718 DOI: 10.3390/pharmaceutics16010102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 01/07/2024] [Accepted: 01/09/2024] [Indexed: 01/24/2024] Open
Abstract
The administration of therapeutics to peripheral nerve tissue is challenging due to the complexities of peripheral neuroanatomy and the limitations imposed by the blood-nerve barrier (BNB). Therefore, there is a pressing need to enhance delivery effectiveness and implement targeted delivery methods. Recently, erythrocyte-derived exosomes (Exos) have gained widespread attention as biocompatible vehicles for therapeutics in clinical applications. However, engineering targeted Exos for the peripheral nervous system (PNS) is still challenging. This study aims to develop a targeted Exo delivery system specifically designed for presynaptic terminals of peripheral nerve tissue. The clostridium neurotoxin, tetanus toxin-C fragment (TTC), was tethered to the surface of red blood cell (RBC)-derived Exos via a facile and efficient bio-orthogonal click chemistry method without a catalyst. Additionally, Cyanine5 (Cy5), a reactive fluorescent tag, was also conjugated to track Exo movement in both in vitro and in vivo models. Subsequently, Neuro-2a, a mouse neuronal cell line, was treated with dye-labeled Exos with/without TTC in vitro, and the results indicated that TTC-Exos exhibited more efficient accumulation along the soma and axonal circumference, compared to their unmodified counterparts. Further investigation, using a mouse model, revealed that within 72 h of intramuscular administration, engineered TTC-Exos were successfully transported into the neuromuscular junction and sciatic nerve tissues. These results indicated that TTC played a crucial role in the Exo delivery system, improving the affinity to peripheral nerves. These promising results underscore the potential of using targeted Exo carriers to deliver therapeutics for treating peripheral neuropathies.
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Affiliation(s)
- Mena Asha Krishnan
- Mary and Dick Holland Regenerative Medicine Program, University of Nebraska Medical Center, Omaha, NE 68198, USA; (M.A.K.); (O.A.A.); (T.P.); (M.K.)
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Olawale A. Alimi
- Mary and Dick Holland Regenerative Medicine Program, University of Nebraska Medical Center, Omaha, NE 68198, USA; (M.A.K.); (O.A.A.); (T.P.); (M.K.)
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Tianshu Pan
- Mary and Dick Holland Regenerative Medicine Program, University of Nebraska Medical Center, Omaha, NE 68198, USA; (M.A.K.); (O.A.A.); (T.P.); (M.K.)
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Mitchell Kuss
- Mary and Dick Holland Regenerative Medicine Program, University of Nebraska Medical Center, Omaha, NE 68198, USA; (M.A.K.); (O.A.A.); (T.P.); (M.K.)
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Zeljka Korade
- Department of Pediatrics, University of Nebraska Medical Center, Omaha, NE 68198, USA;
- Child Health Research Institute, Omaha, NE 68198, USA
- Department of Biochemistry and Molecular Biology, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Guoku Hu
- Department of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE 68198, USA;
| | - Bo Liu
- Mary and Dick Holland Regenerative Medicine Program, University of Nebraska Medical Center, Omaha, NE 68198, USA; (M.A.K.); (O.A.A.); (T.P.); (M.K.)
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Bin Duan
- Mary and Dick Holland Regenerative Medicine Program, University of Nebraska Medical Center, Omaha, NE 68198, USA; (M.A.K.); (O.A.A.); (T.P.); (M.K.)
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA
- Department of Surgery, University of Nebraska Medical Center, Omaha, NE 68198, USA
- Department of Mechanical and Materials Engineering, University of Nebraska Lincoln, Lincoln, NE 68588, USA
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Arora S, Bajaj T, Kumar J, Goyal M, Singh A, Singh C. Recent Advances in Delivery of Peptide and Protein Therapeutics to the Brain. J Pharmacol Exp Ther 2024; 388:54-66. [PMID: 37977811 DOI: 10.1124/jpet.123.001690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 10/05/2023] [Accepted: 10/25/2023] [Indexed: 11/19/2023] Open
Abstract
The classes of neuropharmaceuticals known as proteins and peptides serve as diagnostic tools and are involved in specific communication in the peripheral and central nervous systems. However, due to tight junctions resembling epithelial cells found in the blood-brain barrier (BBB) in vivo, they are typically excluded from transport from the blood to the brain. The drugs having molecular weight of less than 400 Dalton are able to cross the BBB via lipid-mediated free diffusion. However, large molecule therapeutics are devoid of these characteristics. As an alternative, these substances may be carried via chimeric peptide drug delivery systems, and assist in transcytosis through BBB with the aid of linker strategies. With their recent developments, several forms of nanoparticles, including poly (ethylene glycol)-poly(ε-caprolactone) copolymers, nanogels, liposomes, nanostructured lipid carriers, poly (D, L-lactide-co-glycolide) nanoparticles, chitosan, and solid lipid nanoparticles, have also been considered for their therapeutic applications. Moreover, the necessity for physiologic optimization of current drug delivery methods and their carriers to deliver therapeutic doses of medication into the brain for the treatment of various neurologic illnesses has also been emphasized. Therapeutic use of proteins and peptides has no neuroprotective impact in the absence of all these methods. Each tactic, however, has unique drawbacks and considerations. In this review, we discuss different drug delivery methods for therapeutic distribution of pharmaceuticals, primarily neuroproteins and neuropeptides, through endothelial capillaries via blood-brain barrier. Finally, we have also discussed the challenges and future perspective of protein and peptide therapeutics delivery to the brain. SIGNIFICANCE STATEMENT: Very few reports on the delivery of therapeutic protein and peptide nanoformulations are available in the literature. Herein, we attempted to discuss these nanoformulations of protein and peptide therapeutics used to treat brain diseases.
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Affiliation(s)
- Sanchit Arora
- Maa Saraswati College of Pharmacy, Abohar-Sito Road, VPO Kala Tibba, Punjab, India (S.A.); Department of Pharmaceutics, ISF College of Pharmacy, Punjab, India Affiliated to I.K. Gujral Punjab Technical University, formerly Punjab Technical University, Punjab, India (T.B., C.S.); Department of Pharmaceutical Sciences, School of Sciences, Hemvati Nandan Bahuguna Garhwal University (A Central University), Uttarakhand, India (J.K., M.G., C.S.); and Department of Pharmacology, ISF College of Pharmacy, Punjab, India (A.S.)
| | - Tania Bajaj
- Maa Saraswati College of Pharmacy, Abohar-Sito Road, VPO Kala Tibba, Punjab, India (S.A.); Department of Pharmaceutics, ISF College of Pharmacy, Punjab, India Affiliated to I.K. Gujral Punjab Technical University, formerly Punjab Technical University, Punjab, India (T.B., C.S.); Department of Pharmaceutical Sciences, School of Sciences, Hemvati Nandan Bahuguna Garhwal University (A Central University), Uttarakhand, India (J.K., M.G., C.S.); and Department of Pharmacology, ISF College of Pharmacy, Punjab, India (A.S.)
| | - Jayant Kumar
- Maa Saraswati College of Pharmacy, Abohar-Sito Road, VPO Kala Tibba, Punjab, India (S.A.); Department of Pharmaceutics, ISF College of Pharmacy, Punjab, India Affiliated to I.K. Gujral Punjab Technical University, formerly Punjab Technical University, Punjab, India (T.B., C.S.); Department of Pharmaceutical Sciences, School of Sciences, Hemvati Nandan Bahuguna Garhwal University (A Central University), Uttarakhand, India (J.K., M.G., C.S.); and Department of Pharmacology, ISF College of Pharmacy, Punjab, India (A.S.)
| | - Manoj Goyal
- Maa Saraswati College of Pharmacy, Abohar-Sito Road, VPO Kala Tibba, Punjab, India (S.A.); Department of Pharmaceutics, ISF College of Pharmacy, Punjab, India Affiliated to I.K. Gujral Punjab Technical University, formerly Punjab Technical University, Punjab, India (T.B., C.S.); Department of Pharmaceutical Sciences, School of Sciences, Hemvati Nandan Bahuguna Garhwal University (A Central University), Uttarakhand, India (J.K., M.G., C.S.); and Department of Pharmacology, ISF College of Pharmacy, Punjab, India (A.S.)
| | - Arti Singh
- Maa Saraswati College of Pharmacy, Abohar-Sito Road, VPO Kala Tibba, Punjab, India (S.A.); Department of Pharmaceutics, ISF College of Pharmacy, Punjab, India Affiliated to I.K. Gujral Punjab Technical University, formerly Punjab Technical University, Punjab, India (T.B., C.S.); Department of Pharmaceutical Sciences, School of Sciences, Hemvati Nandan Bahuguna Garhwal University (A Central University), Uttarakhand, India (J.K., M.G., C.S.); and Department of Pharmacology, ISF College of Pharmacy, Punjab, India (A.S.)
| | - Charan Singh
- Maa Saraswati College of Pharmacy, Abohar-Sito Road, VPO Kala Tibba, Punjab, India (S.A.); Department of Pharmaceutics, ISF College of Pharmacy, Punjab, India Affiliated to I.K. Gujral Punjab Technical University, formerly Punjab Technical University, Punjab, India (T.B., C.S.); Department of Pharmaceutical Sciences, School of Sciences, Hemvati Nandan Bahuguna Garhwal University (A Central University), Uttarakhand, India (J.K., M.G., C.S.); and Department of Pharmacology, ISF College of Pharmacy, Punjab, India (A.S.)
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Changkakoti L, Das JM, Borah R, Rajabalaya R, David SR, Balaraman AK, Pramanik S, Haldar PK, Bala A. Protein Kinase C (PKC)-mediated TGF-β Regulation in Diabetic Neuropathy: Emphasis on Neuro-inflammation and Allodynia. Endocr Metab Immune Disord Drug Targets 2024; 24:777-788. [PMID: 37937564 DOI: 10.2174/0118715303262824231024104849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/08/2023] [Accepted: 09/25/2023] [Indexed: 11/09/2023]
Abstract
According to the World Health Organization (WHO), diabetes has been increasing steadily over the past few decades. In developing countries, it is the cause of increased morbidity and mortality. Diabetes and its complications are associated with education, occupation, and income across all levels of socioeconomic status. Factors, such as hyperglycemia, social ignorance, lack of proper health knowledge, and late access to medical care, can worsen diabetic complications. Amongst the complications, neuropathic pain and inflammation are considered the most common causes of morbidity for common populations. This review is focused on exploring protein kinase C (PKC)-mediated TGF-946; regulation in diabetic complications with particular emphasis on allodynia. The role of PKC-triggered TGF-946; in diabetic neuropathy is not well explored. This review will provide a better understanding of the PKC-mediated TGF-946; regulation in diabetic neuropathy with several schematic illustrations. Neuroinflammation and associated hyperalgesia and allodynia during microvascular complications in diabetes are scientifically illustrated in this review. It is hoped that this review will facilitate biomedical scientists to better understand the etiology and target drugs effectively to manage diabetes and diabetic neuropathy.
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Affiliation(s)
- Liza Changkakoti
- Pharmacology and Drug Discovery Research Laboratory, Division of Life Sciences, Institute of Advanced Study in Science and Technology (IASST), An Autonomous Institute Under - Department of Science & Technology (Govt. of India) Vigyan Path, Guwahati, PIN- 781035 Assam, India
| | - Jitu Mani Das
- Pharmacology and Drug Discovery Research Laboratory, Division of Life Sciences, Institute of Advanced Study in Science and Technology (IASST), An Autonomous Institute Under - Department of Science & Technology (Govt. of India) Vigyan Path, Guwahati, PIN- 781035 Assam, India
| | - Rajiv Borah
- Department of Mechanical, Manufacturing and Biomedical Engineering, Trinity College Dublin, The University of Dublin, Dublin, Ireland
| | - Rajan Rajabalaya
- PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, BE 1410 Bandar Seri Begawan, Brunei Darussalam
| | - Sheba Rani David
- School of Pharmacology, University of Wyoming, Laramie, Wyoming, 82071, USA
| | - Ashok Kumar Balaraman
- Faculty of Pharmacy, MAHSA University, Bandar Saujana Putra, 42610, Jenjarom, Selangor, Malaysia
| | - Subrata Pramanik
- Jyoti and Bhupat Mehta School of Health Sciences & Technology, Indian Institute of Technology (IIT), Guwahati, Assam- 781039, India
| | - Pallab Kanti Haldar
- Department of Pharmaceutical Technology, Division of Pharmacology & Toxicology, Jadavpur University, Kolkata, 700032, India
| | - Asis Bala
- Pharmacology and Drug Discovery Research Laboratory, Division of Life Sciences, Institute of Advanced Study in Science and Technology (IASST), An Autonomous Institute Under - Department of Science & Technology (Govt. of India) Vigyan Path, Guwahati, PIN- 781035 Assam, India
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Zhang J, Gao L, Zhang Y, Wang H, Sun S, Wu L. Involvement of microglial P2X7 receptor in pain modulation. CNS Neurosci Ther 2024; 30:e14496. [PMID: 37950524 PMCID: PMC10805404 DOI: 10.1111/cns.14496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 08/23/2023] [Accepted: 10/02/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Pain is a rapid response mechanism that compels organisms to retreat from the harmful stimuli and triggers a repair response. Nonetheless, when pain persists for extended periods, it can lead to adverse changes into in the individual's brain, negatively impacting their emotional state and overall quality of life. Microglia, the resident immune cells in the central nervous system (CNS), play a pivotal role in regulating a variety of pain-related disorders. Specifically, recent studies have shed light on the central role that microglial purinergic ligand-gated ion channel 7 receptor (P2X7R) plays in regulating pain. In this respect, the P2X7R on microglial membranes represents a potential therapeutic target. AIMS To expound on the intricate link between microglial P2X7R and pain, offering insights into potential avenues for future research. METHODS We reviewed 140 literature and summarized the important role of microglial P2X7R in regulating pain, including the structure and function of P2X7R, the relationship between P2X7R and microglial polarization, P2X7R-related signaling pathways, and the effects of P2X7R antagonists on pain regulation. RESULTS P2X7R activation is related to M1 polarization of microglia, while suppressing P2X7R can transfer microglia from M1 into M2 phenotype. And targeting the P2X7R-mediated signaling pathways helps to explore new therapy for pain alleviation. P2X7R antagonists also hold potential for translational and clinical applications in pain management. CONCLUSIONS Microglial P2X7R holds promise as a potential novel pharmacological target for clinical treatments due to its distinctive structure, function, and the development of antagonists.
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Affiliation(s)
- Jing Zhang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Department of Pediatric Dentistry, School of StomatologyThe Fourth Military Medical UniversityXi'anShaanxiChina
| | - Lei Gao
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Department of Pediatric Dentistry, School of StomatologyThe Fourth Military Medical UniversityXi'anShaanxiChina
| | - Yaoyuan Zhang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Department of Pediatric Dentistry, School of StomatologyThe Fourth Military Medical UniversityXi'anShaanxiChina
| | - Haozhen Wang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Department of Pediatric Dentistry, School of StomatologyThe Fourth Military Medical UniversityXi'anShaanxiChina
| | - Shukai Sun
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Department of Pediatric Dentistry, School of StomatologyThe Fourth Military Medical UniversityXi'anShaanxiChina
| | - Li‐an Wu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Department of Pediatric Dentistry, School of StomatologyThe Fourth Military Medical UniversityXi'anShaanxiChina
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Einhorn LM, Hudon J, Ingelmo P. The Pharmacological Treatment of Neuropathic Pain in Children. Curr Neuropharmacol 2024; 22:38-52. [PMID: 37539933 DOI: 10.2174/1570159x21666230804110858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 02/22/2023] [Accepted: 03/12/2023] [Indexed: 08/05/2023] Open
Abstract
The International Association for the Study of Pain (IASP) defines neuropathic pain as pain caused by a lesion or disease of the somatosensory nervous system. It is characterized as a clinical condition in which diagnostic studies reveal an underlying cause of an abnormality in the peripheral or central nervous system. Many common causes of neuropathic pain in adults are rare in children. The purpose of this focused narrative review is, to 1) provide an overview of neuropathic pain in children, 2) highlight unique considerations related to the diagnosis and mechanisms of neuropathic pain in children, and 3) perform a comprehensive analysis of the pharmacological treatments available. We emphasize that data for routine use of pharmacological agents in children with neuropathic pain are largely inferred from adult literature with little research performed on pediatric populations, yet have clear evidence of harms to pediatric patients. Based on these findings, we propose risk mitigation strategies such as utilizing topical treatments whenever possible, assessing pain phenotyping to guide drug class choice, and considering pharmaceuticals in the broader context of the multidisciplinary treatment of pediatric pain. Furthermore, we highlight important directions for future research on pediatric neuropathic pain treatment.
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Affiliation(s)
- Lisa M Einhorn
- Department of Anesthesiology, Pediatric Division, Duke University School of Medicine, Durham, North Carolina, United States
| | - Jonathan Hudon
- Division of Secondary Care, Department of Family Medicine, McGill University Health Centre, Montreal, Qc, Canada
- Palliative Care Division, Jewish General Hospital, Montreal, Qc, Canada
- Alan Edwards Pain Management Unit, Montreal General Hospital, McGill University Health Center, Montreal, Qc, Canada
- Alan Edwards Centre for Pain Research, McGill University, Montreal, Canada
- Edwards Family Interdisciplinary Centre for Complex Pain, Montreal Children's Hospital, McGill University Health Center, Montreal, Canada
| | - Pablo Ingelmo
- Alan Edwards Centre for Pain Research, McGill University, Montreal, Canada
- Edwards Family Interdisciplinary Centre for Complex Pain, Montreal Children's Hospital, McGill University Health Center, Montreal, Canada
- Research Institute of the McGill University Health Center, Montreal, Canada
- Department of Pediatric Anesthesia, Montreal Children's Hospital, McGill University Health Center, Montréal, QC, Canada
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Dashtestani P, Karami L. The molecular mechanism of the effects of the anti-neuropathic ligands on the modulation of the Sigma-2 receptor: An in-silico study. Int J Biol Macromol 2024; 254:127925. [PMID: 37944735 DOI: 10.1016/j.ijbiomac.2023.127925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 11/03/2023] [Accepted: 11/04/2023] [Indexed: 11/12/2023]
Abstract
Neuropathic pain (NP) is a prevalent medical condition that lacks an effective treatment. Recently, the Sigma-2 receptor (S2R) has been proposed as a potential therapeutic target for NP. Some highly-selective S2R ligands (UKH1114, CM398, and YTD) have shown promising results in vivo, but the molecular interaction between the S2R and these ligands has been scarcely investigated. This work explores changes in the S2R upon interaction with the three mentioned ligands using in silico approaches. The results indicated that the ICL1, H1, ICL2, and ECL are the most dynamic regions of S2R in all systems. Binding interaction analysis identified amino acids with significant contribution to the binding free energy. Notably, the UKH1114-S2R simulation trajectory revealed that small alterations in the ICL1, H1, ICL2, and ECL form a new stable opening in the S2R, linking the occluded S2R binding pocket to the endoplasmic reticulum lumen, providing more evidence for the assumptions about the EBP and S2R mechanism of function. Further, the agreement between the membrane parameters in our study and experimental values confirms the validity of the MD simulations. Overall, this study provides new insights into the interaction between anti-NP ligands and the S2R.
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Affiliation(s)
- Parisa Dashtestani
- Department of Cell and Molecular Biology, Faculty of Biological Sciences, Kharazmi University, Tehran, Iran
| | - Leila Karami
- Department of Cell and Molecular Biology, Faculty of Biological Sciences, Kharazmi University, Tehran, Iran.
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Chen L, Zhang Z, Han R, Li K, Guo G, Huang D, Huang Y, Zhou H. Correlation between spinal cord stimulation analgesia and cortical dynamics in pain management. Ann Clin Transl Neurol 2024; 11:57-66. [PMID: 37903713 PMCID: PMC10791032 DOI: 10.1002/acn3.51932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 10/10/2023] [Accepted: 10/14/2023] [Indexed: 11/01/2023] Open
Abstract
AIM Spinal cord stimulation (SCS) is an effective method to treat neuropathic pain. It is necessary to identify the responders of SCS analgesia before implantation. The aim of this study is to investigate the relationship between the cortical dynamics and SCS analgesia responders in pain management. METHODS Resting-state EEG recording was performed in patients who underwent short-term implantation of spinal cord stimulation for pain therapy. We then did spectral analysis to capture the pattern of cortical oscillation between neuromodulation therapy analgesia responders and nonresponders. RESULTS About 58.3% (14 out of 24) of participants were considered as analgesia responders, with average visual analogue scores reduction of 4.8 ± 1.0 after surgery, and 2.1 ± 0.7 for the nonresponder subgroup, respectively. The alpha oscillation was significantly enhanced in responder cohort compared with nonresponders. We also observed an increasing spectral power of gamma band in responders. Furthermore, the attenuation of pain severity was significantly correlated with the global alpha oscillation activity (r = 0.60, P = 0.002). Likely, positive and significant correlation was found between the pain relief and gamma activity (r = 0.58, P = 0.003). CONCLUSIONS Distinct pattern of neural oscillation is associated with the analgesic effect of spinal cord stimulation in pain management, enhancement of cortical alpha and gamma oscillation may be a predictor of analgesia responders.
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Affiliation(s)
- Li Chen
- Department of PainThe Third Xiangya Hospital and Institute of Pain Medicine, Central South UniversityChangsha410013China
- Department of AnesthesiologyThe Affiliated Changsha Central Hospital, Hengyang Medical School, University of South ChinaChangsha410028China
| | - Zhen Zhang
- Department of PainThe Third Xiangya Hospital and Institute of Pain Medicine, Central South UniversityChangsha410013China
| | - Rui Han
- Department of PainThe Third Xiangya Hospital and Institute of Pain Medicine, Central South UniversityChangsha410013China
| | - Kuankuan Li
- Department of PainThe Third Xiangya Hospital and Institute of Pain Medicine, Central South UniversityChangsha410013China
| | - Gangwen Guo
- Department of PainThe Third Xiangya Hospital and Institute of Pain Medicine, Central South UniversityChangsha410013China
| | - Dong Huang
- Department of PainThe Third Xiangya Hospital and Institute of Pain Medicine, Central South UniversityChangsha410013China
- Hunan Key Laboratory of Brain HomeostasisCentral South UniversityChangsha410013China
| | - Yuzhao Huang
- Department of OrthopaedicsThe Third Xiangya Hospital, Central South UniversityChangshaHunan410013China
| | - Haocheng Zhou
- Department of PainThe Third Xiangya Hospital and Institute of Pain Medicine, Central South UniversityChangsha410013China
- Hunan Key Laboratory of Brain HomeostasisCentral South UniversityChangsha410013China
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Benamar K. IUPHAR review- Preclinical models of neuropathic pain: Evaluating multifunctional properties of natural cannabinoid receptors ligands. Pharmacol Res 2024; 199:107013. [PMID: 38008135 DOI: 10.1016/j.phrs.2023.107013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 11/20/2023] [Accepted: 11/21/2023] [Indexed: 11/28/2023]
Abstract
Neuropathic pain remains prevalent and challenging to manage and is often comorbid with depression and anxiety. The new approach that simultaneously targets neuropathic pain and the associated comorbidities, such as depression and anxiety, is timely and critical, given the high prevalence and severity of neuropathic pain and the lack of effective analgesics. In this review, we focus on the animal models of neuropathic pain that researchers have used to investigate the analgesic effects of cannabidiol (CBD) and Beta-Caryophyllene (BCP) individually and in combination while addressing the impact of these compounds on the major comorbidity (e.g., depression, anxiety) associated with neuropathic pain. We also addressed the potential targets/mechanisms by which CBD and BCP produce analgesic effects in neuropathic pain models. The preclinical studies examined in this review support CBD and BCP individually and combined as potential alternative analgesics for neuropathic pain while showing beneficial effects on depression and anxiety.
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Affiliation(s)
- Khalid Benamar
- Institute of Neuroscience and Department of Neuro-behavioral Health, University of Texas Rio Grande Valley, School of Medicine, Biomedical building, McAllen, TX 78504, USA.
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Tao Y, Wang QH, Li XT, Liu Y, Sun RH, Xu HJ, Zhang M, Li SY, Yang L, Wang HJ, Hao LY, Cao JL, Pan Z. Spinal-Specific Super Enhancer in Neuropathic Pain. J Neurosci 2023; 43:8547-8561. [PMID: 37802656 PMCID: PMC10711714 DOI: 10.1523/jneurosci.1006-23.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 08/31/2023] [Accepted: 10/01/2023] [Indexed: 10/08/2023] Open
Abstract
Dysfunctional gene expression in nociceptive pathways plays a critical role in the development and maintenance of neuropathic pain. Super enhancers (SEs), composed of a large cluster of transcriptional enhancers, are emerging as new players in the regulation of gene expression. However, whether SEs participate in nociceptive responses remains unknown. Here, we report a spinal-specific SE (SS-SE) that regulates chronic constriction injury (CCI)-induced neuropathic pain by driving Ntmt1 and Prrx2 transcription in dorsal horn neurons. Peripheral nerve injury significantly enhanced the activity of SS-SE and increased the expression of NTMT1 and PRRX2 in the dorsal horn of male mice in a bromodomain-containing protein 4 (BRD4)-dependent manner. Both intrathecal administration of a pharmacological BRD4 inhibitor JQ1 and CRISPR-Cas9-mediated SE deletion abolished the increased NTMT1 and PRRX2 in CCI mice and attenuated their nociceptive hypersensitivities. Furthermore, knocking down Ntmt1 or Prrx2 with siRNA suppressed the injury-induced elevation of phosphorylated extracellular-signal-regulated kinase (p-ERK) and glial fibrillary acidic protein (GFAP) expression in the dorsal horn and alleviated neuropathic pain behaviors. Mimicking the increase in spinal Ntmt1 or Prrx2 in naive mice increased p-ERK and GFAP expression and led to the genesis of neuropathic pain-like behavior. These results redefine our understanding of the regulation of pain-related genes and demonstrate that BRD4-driven increases in SS-SE activity is responsible for the genesis of neuropathic pain through the governance of NTMT1 and PRRX2 expression in dorsal horn neurons. Our findings highlight the therapeutic potential of BRD4 inhibitors for the treatment of neuropathic pain.SIGNIFICANCE STATEMENT SEs drive gene expression by recruiting master transcription factors, cofactors, and RNA polymerase, but their role in the development of neuropathic pain remains unknown. Here, we report that the activity of an SS-SE, located upstream of the genes Ntmt1 and Prrx2, was elevated in the dorsal horn of mice with neuropathic pain. SS-SE contributes to the genesis of neuropathic pain by driving expression of Ntmt1 and Prrx2 Both inhibition of SS-SE with a pharmacological BRD4 inhibitor and genetic deletion of SS-SE attenuated pain hypersensitivities. This study suggests an effective and novel therapeutic strategy for neuropathic pain.
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Affiliation(s)
- Yang Tao
- Jiangsu Province Key Laboratory of Anesthesiology, Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application Technology, NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou 221004, China
| | - Qi-Hui Wang
- Jiangsu Province Key Laboratory of Anesthesiology, Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application Technology, NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou 221004, China
| | - Xiao-Tong Li
- Jiangsu Province Key Laboratory of Anesthesiology, Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application Technology, NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou 221004, China
| | - Ya Liu
- Jiangsu Province Key Laboratory of Anesthesiology, Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application Technology, NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou 221004, China
| | - Run-Hang Sun
- Jiangsu Province Key Laboratory of Anesthesiology, Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application Technology, NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou 221004, China
| | - Heng-Jun Xu
- Jiangsu Province Key Laboratory of Anesthesiology, Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application Technology, NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou 221004, China
| | - Ming Zhang
- Jiangsu Province Key Laboratory of Anesthesiology, Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application Technology, NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou 221004, China
| | - Si-Yuan Li
- Jiangsu Province Key Laboratory of Anesthesiology, Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application Technology, NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou 221004, China
| | - Li Yang
- Jiangsu Province Key Laboratory of Anesthesiology, Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application Technology, NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou 221004, China
| | - Hong-Jun Wang
- Jiangsu Province Key Laboratory of Anesthesiology, Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application Technology, NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou 221004, China
| | - Ling-Yun Hao
- Jiangsu Province Key Laboratory of Anesthesiology, Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application Technology, NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou 221004, China
| | - Jun-Li Cao
- Jiangsu Province Key Laboratory of Anesthesiology, Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application Technology, NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou 221004, China
| | - Zhiqiang Pan
- Jiangsu Province Key Laboratory of Anesthesiology, Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application Technology, NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou 221004, China
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HajAli T, Shmaisani A, Fares Y, Abou-Abbas L. Predictors of neuropathic pain and related functional disability in sciatica patients: a cross-sectional study. Int J Neurosci 2023; 133:1338-1345. [PMID: 35603462 DOI: 10.1080/00207454.2022.2079504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 05/12/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE The aim of the present paper was to assess neuropathic pain and its predictors among patients with sciatica. In addition, we sought to investigate the predictors of functional disability in sciatica patients with neuropathic pain. METHODS A cross-sectional study was carried out on a sample of 100 sciatica patients aged 18 years and older with a radiating pain from the lower back down to the leg below the knee. Information about socio-demographic characteristics, duration of symptoms, being treated or not, type of treatment, side of sciatica, presence of back pain, leg pain occurrence, leg pain intensity, functional disability and pain catastrophizing were collected. RESULTS Of the total patients, 57% had neuropathic pain. Multivariable analysis showed that leg pain intensity was higher in the neuropathic pain group as compared to the non-neuropathic pain group. Also, patients with left sciatica were less likely to have neuropathic pain than patients with right sciatica. Patients with neuropathic pain having high levels of pain catastrophizing and being on bed rest for at least one week were at a higher risk of developing functional disability as compared to their counterparts. CONCLUSION Low levels of pain catastrophizing and less bed rest should be considered in interventions aimed at improving the functional ability for sciatica patients with neuropathic pain.
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Affiliation(s)
- Thuraya HajAli
- Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | - Ammar Shmaisani
- Neurosurgery Department, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | - Youssef Fares
- Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
- Neurosurgery Department, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | - Linda Abou-Abbas
- Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
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Gong C, Zhong W, Zhu C, Chen B, Guo J. Research Trends and Hotspots of Neuromodulation in Neuropathic Pain: A Bibliometric Analysis. World Neurosurg 2023; 180:155-162.e2. [PMID: 37380050 DOI: 10.1016/j.wneu.2023.06.090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 06/19/2023] [Indexed: 06/30/2023]
Abstract
BACKGROUND Neuropathic pain (NeuP), the result of a lesion or disease of the somatosensory nervous system, is tricky to cure clinically. Mounting researches reveal that neuromodulation can safely and effectively ameliorate NeuP. The number of publications associated with neuromodulation and NeuP increases with time. However, bibliometric analysis on the field is rare. The present study aims to analyze trends and topics in neuromodulation and NeuP research by using a bibliometric method. METHODS This study systematically collected the relevant publications on the Science Citation Index Expanded of Web of Science from January 1994 to January 17, 2023. CiteSpace software was used to draw and analyze corresponding visualization maps. RESULTS A total of 1404 publications were ultimately obtained under our specified inclusion criteria. The analysis showed that the focus of research on neuromodulation and NeuP had been developing steadily in recent years, with papers published in 58 countries/regions and 411 academic journals. The Journal of Neuromodulation and the author J.P. Lefaucheur published the most papers. The papers published in Harvard University and the United States contributed significantly. The cited keywords show that motor cortex stimulation, spinal cord stimulation, electrical stimulation, transcranial magnetic stimulation, and mechanism are the research hotspots in the field. CONCLUSIONS The bibliometric analysis showed that the number of publications on neuromodulation and NeuP are increasing rapidly, especially in the past 5 years. "Motor cortex stimulation," "electrical stimulation," "spinal cord stimulation," "transcranial magnetic stimulation" and "mechanism" catch the most attention among researchers in this field.
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Affiliation(s)
- Chan Gong
- The Second School of Clinical Medical, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Weiquan Zhong
- The Second School of Clinical Medical, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Chenchen Zhu
- The Second School of Clinical Medical, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Binglin Chen
- The Second School of Clinical Medical, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Jiabao Guo
- The Second School of Clinical Medical, Xuzhou Medical University, Xuzhou, Jiangsu, China.
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Liu N, Zhang GX, Zhu CH, Lan XB, Tian MM, Zheng P, Peng XD, Li YX, Yu JQ. Antinociceptive and neuroprotective effect of echinacoside on peripheral neuropathic pain in mice through inhibiting P2X7R/FKN/CX3CR1 pathway. Biomed Pharmacother 2023; 168:115675. [PMID: 37812887 DOI: 10.1016/j.biopha.2023.115675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 10/04/2023] [Accepted: 10/06/2023] [Indexed: 10/11/2023] Open
Abstract
Clinically, neuropathic pain treatment remains a challenging issue because the major therapy, centred around pharmacological intervention, is not satisfactory enough to patient by reason of low effectiveness and more adverse reaction. Therefore, it is still necessary to find more effective and safe therapy to ameliorate neuropathic pain. The purpose of this study was to explore the antinociceptive effect of Echinacoside (ECH), an active compound of Cistanche deserticola Ma, on peripheral neuropathic pain induced by chronic constriction injury (CCI) in mice, and to demonstrate its potential mechanism in vivo and vitro. In the present study, results showed that intraperitoneal administration of ECH (50, 100, and 200 mg/kg) could alleviate mechanical allodynia, cold allodynia and thermal hyperalgesia via behavioural test. Moreover, the structure and function of injured sciatic nerve by CCI were taken a turn for the better to a certain extent after ECH treatment using histopathological and electrophysiological test. Furthermore, ECH repressed the expression of the P2X7R and FKN and reduced the expression and release of the IL-1β, IL-6 and TNF-α. Besides, ECH could decrease Ca2+ influx and Cats efflux and inhibit phosphorylation of p38MAPK. To sum up, the present study illustrated that ECH could alleviate peripheral neuropathic pain by inhibiting microglia overactivation and inflammation through P2X7R/FKN/CX3CR1 signalling pathway in spinal cord. This study would provide a new perspective and strategy for the pharmacological treatment on neuropathic pain.
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Affiliation(s)
- Ning Liu
- Ningxia Key Laboratory of Drug Development and Generic Drug Research, School of Pharmacy, Ningxia Medical University, Yinchuan, China
| | - Guo-Xin Zhang
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
| | - Chun-Hao Zhu
- School of Basic Medical Sciences, Ningxia Medical University, Yinchuan, China
| | - Xiao-Bing Lan
- Ningxia Key Laboratory of Drug Development and Generic Drug Research, School of Pharmacy, Ningxia Medical University, Yinchuan, China
| | - Miao-Miao Tian
- Ningxia Key Laboratory of Drug Development and Generic Drug Research, School of Pharmacy, Ningxia Medical University, Yinchuan, China
| | - Ping Zheng
- Ningxia Key Laboratory of Drug Development and Generic Drug Research, School of Pharmacy, Ningxia Medical University, Yinchuan, China
| | - Xiao-Dong Peng
- Ningxia Key Laboratory of Drug Development and Generic Drug Research, School of Pharmacy, Ningxia Medical University, Yinchuan, China
| | - Yu-Xiang Li
- School of Nursing, Ningxia Medical University, Yinchuan, China.
| | - Jian-Qiang Yu
- Ningxia Key Laboratory of Drug Development and Generic Drug Research, School of Pharmacy, Ningxia Medical University, Yinchuan, China.
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Gabarin A, Yarmolinsky L, Budovsky A, Khalfin B, Ben-Shabat S. Cannabis as a Source of Approved Drugs: A New Look at an Old Problem. Molecules 2023; 28:7686. [PMID: 38067416 PMCID: PMC10707504 DOI: 10.3390/molecules28237686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 11/09/2023] [Accepted: 11/15/2023] [Indexed: 12/18/2023] Open
Abstract
Cannabis plants have been used in medicine since ancient times. They are well known for their anti-diabetic, anti-inflammatory, neuroprotective, anti-cancer, anti-oxidative, anti-microbial, anti-viral, and anti-fungal activities. A growing body of evidence indicates that targeting the endocannabinoid system and various other receptors with cannabinoid compounds holds great promise for addressing multiple medical conditions. There are two distinct avenues in the development of cannabinoid-based drugs. The first involves creating treatments directly based on the components of the cannabis plant. The second involves a singular molecule strategy, in which specific phytocannabinoids or newly discovered cannabinoids with therapeutic promise are pinpointed and synthesized for future pharmaceutical development and validation. Although the therapeutic potential of cannabis is enormous, few cannabis-related approved drugs exist, and this avenue warrants further investigation. With this in mind, we review here the medicinal properties of cannabis, its phytochemicals, approved drugs of natural and synthetic origin, pitfalls on the way to the widespread clinical use of cannabis, and additional applications of cannabis-related products.
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Affiliation(s)
- Adi Gabarin
- The Department of Clinical Biochemistry & Pharmacology, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva 84105, Israel; (A.G.); (L.Y.); (B.K.)
| | - Ludmila Yarmolinsky
- The Department of Clinical Biochemistry & Pharmacology, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva 84105, Israel; (A.G.); (L.Y.); (B.K.)
| | - Arie Budovsky
- Research and Development Authority, Barzilai University Medical Center, Ashkelon 7830604, Israel;
| | - Boris Khalfin
- The Department of Clinical Biochemistry & Pharmacology, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva 84105, Israel; (A.G.); (L.Y.); (B.K.)
| | - Shimon Ben-Shabat
- The Department of Clinical Biochemistry & Pharmacology, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva 84105, Israel; (A.G.); (L.Y.); (B.K.)
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Bateman EA, Larocerie-Salgado J, Ross DC, Miller TA, Pripotnev S. Assessment, patient selection, and rehabilitation of nerve transfers. FRONTIERS IN REHABILITATION SCIENCES 2023; 4:1267433. [PMID: 38058570 PMCID: PMC10696649 DOI: 10.3389/fresc.2023.1267433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 11/07/2023] [Indexed: 12/08/2023]
Abstract
Peripheral nerve injuries are common and can have a devastating effect on physical, psychological, and socioeconomic wellbeing. Peripheral nerve transfers have become the standard of care for many types of peripheral nerve injury due to their superior outcomes relative to conventional techniques. As the indications for, and use of, nerve transfers expand, the importance of pre-operative assessment and post-operative optimization increases. There are two principal advantages of nerve transfers: (1) their ability to shorten the time to reinnervation of muscles undergoing denervation because of peripheral nerve injury; and (2) their specificity in ensuring proximal motor and sensory axons are directed towards appropriate motor and sensory targets. Compared to conventional nerve grafting, nerve transfers offer opportunities to reinnervate muscles affected by cervical spinal cord injury and to augment natural reinnervation potential for very proximal injuries. This article provides a narrative review of the current scientific knowledge and clinical understanding of nerve transfers including peripheral nerve injury assessment and pre- and post-operative electrodiagnostic testing, adjuvant therapies, and post-operative rehabilitation for optimizing nerve transfer outcomes.
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Affiliation(s)
- Emma A. Bateman
- Department of Physical Medicine & Rehabilitation, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
- Parkwood Institute, St Joseph’s Health Care London, London, ON, Canada
| | | | - Douglas C. Ross
- Roth McFarlane Hand & Upper Limb Centre, St Joseph’s Health Care London, London, ON, Canada
- Division of Plastic & Reconstructive Surgery, Department of Surgery, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Thomas A. Miller
- Department of Physical Medicine & Rehabilitation, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
- Parkwood Institute, St Joseph’s Health Care London, London, ON, Canada
| | - Stahs Pripotnev
- Roth McFarlane Hand & Upper Limb Centre, St Joseph’s Health Care London, London, ON, Canada
- Division of Plastic & Reconstructive Surgery, Department of Surgery, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
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Elder NM, Heavey SF, Tyler KR. Emergency Department Pain Management in the Older Adult. Clin Geriatr Med 2023; 39:619-634. [PMID: 37798068 DOI: 10.1016/j.cger.2023.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Abstract
Pain assessment and management in older adults is complex and requires evaluation and consideration of the type of pain, the acuity of the condition, comorbidities, and medications. Many older adults do not receive appropriate therapy for painful conditions in the emergency department (ED). This brief review article is focused on pharmacologic agents, drug-drug interactions, drug-disease interactions, and approaches in the management of painful conditions seen in older adults in the emergency department. Recommendations for specific painful conditions such as fragility fractures are discussed.
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Affiliation(s)
- Natalie M Elder
- University of Vermont, 111 Colchester Avenue, Burlington, VT 05401, USA
| | - Sean F Heavey
- University of California Davis, 4150 V Street, Sacramento, CA 95817, USA
| | - Katren R Tyler
- University of California Davis, 4150 V Street, Sacramento, CA 95817, USA.
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Ramawad HA, Paridari P, Jabermoradi S, Gharin P, Toloui A, Safari S, Yousefifard M. Muscimol as a treatment for nerve injury-related neuropathic pain: a systematic review and meta-analysis of preclinical studies. Korean J Pain 2023; 36:425-440. [PMID: 37732408 PMCID: PMC10551397 DOI: 10.3344/kjp.23161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 07/27/2023] [Accepted: 08/01/2023] [Indexed: 09/22/2023] Open
Abstract
Background : Muscimol's quick onset and GABAergic properties make it a promising candidate for the treatment of pain. This systematic review and meta-analysis of preclinical studies aimed at summarizing the evidence regarding the efficacy of muscimol administration in the amelioration of nerve injury-related neuropathic pain. Methods : Two independent researchers performed the screening process in Medline, Embase, Scopus and Web of Science extracting data were extracted into a checklist designed according to the PRISMA guideline. A standardized mean difference (SMD [95% confidence interval]) was calculated for each. To assess the heterogeneity between studies, I2 and chi-square tests were utilized. In the case of heterogeneity, meta-regression and subgroup analyses were performed to identify the potential source. Results : Twenty-two articles met the inclusion criteria. Pooled data analysis showed that the administration of muscimol during the peak effect causes a significant reduction in mechanical allodynia (SMD = 1.78 [1.45-2.11]; P < 0.0001; I2 = 72.70%), mechanical hyperalgesia (SMD = 1.62 [1.28-1.96]; P < 0.0001; I2 = 40.66%), and thermal hyperalgesia (SMD = 2.59 [1.79-3.39]; P < 0.0001; I2 = 80.33%). This significant amendment of pain was observed at a declining rate from 15 minutes to at least 180 minutes post-treatment in mechanical allodynia and mechanical hyperalgesia, and up to 30 minutes in thermal hyperalgesia (P < 0 .0001). Conclusions : Muscimol is effective in the amelioration of mechanical allodynia, mechanical hyperalgesia, and thermal hyperalgesia, exerting its analgesic effects 15 minutes after administration for up to at least 3 hours.
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Affiliation(s)
- Hamzah Adel Ramawad
- Department of Emergency Medicine, NYC Health + Hospitals, Coney Island, NY, USA
| | - Parsa Paridari
- Physiology Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Sajjad Jabermoradi
- Physiology Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Pantea Gharin
- Physiology Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Amirmohammad Toloui
- Physiology Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Saeed Safari
- Men's Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahmoud Yousefifard
- Physiology Research Center, Iran University of Medical Sciences, Tehran, Iran
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Wu L, Tang H. The role of N6-methyladenosine modification in rodent models of neuropathic pain: from the mechanism to therapeutic potential. Biomed Pharmacother 2023; 166:115398. [PMID: 37647691 DOI: 10.1016/j.biopha.2023.115398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 08/25/2023] [Accepted: 08/26/2023] [Indexed: 09/01/2023] Open
Abstract
Neuropathic pain (NP) is a common chronic pain condition resulted from lesions or diseases of somatosensory nervous system, but the pathogenesis remains unclear. A growing body of evidence supports the relationship between pathogenesis and N6-methyladenosine (m6A) modifications of RNA. However, studies on the role of m6A modifications in NP are still at an early stage. Elucidating different etiologies is important for understanding the specific pathogenesis of NP. This article provides a comprehensive review on the role of m6A methylation modifications including methyltransferases ("writers"), demethylases ("erasers"), and m6A binding proteins ("readers") in NP models. Further analysis of the pathogenic mechanism relationship between m6A and NP provided novel theoretical and practical significance for clinical treatment of NP.
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Affiliation(s)
- Liping Wu
- Guangxi University of Traditional Chinese Medicine, Nanning, China; The First Clinical Medical College of Guangxi University of Traditional Chinese Medicine, Nanning, China
| | - Hongliang Tang
- Guangxi Traditional Chinese Medicine University Affiliated Fangchenggang Hospital.
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Xie L, Zhang M, Liu Q, Wei R, Sun M, Zhang Q, Hao L, Xue Z, Wang Q, Yang L, Wang H, Pan Z. Downregulation of ciRNA-Kat6b in dorsal spinal horn is required for neuropathic pain by regulating Kcnk1 in miRNA-26a-dependent manner. CNS Neurosci Ther 2023; 29:2955-2971. [PMID: 37144575 PMCID: PMC10493661 DOI: 10.1111/cns.14235] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 04/03/2023] [Accepted: 04/10/2023] [Indexed: 05/06/2023] Open
Abstract
AIMS Nerve injury-induced maladaptive changes in gene expression in the spinal neurons are essential for neuropathic pain genesis. Circular RNAs (ciRNA) are emerging as key regulators of gene expression. Here, we identified a nervous-system-tissues-specific ciRNA-Kat6 with conservation in humans and mice. We aimed to investigate whether and how spinal dorsal horn ciRNA-Kat6b participates in neuropathic pain. METHODS Unilateral sciatic nerve chronic constrictive injury (CCI) surgery was used to prepare the neuropathic pain model. The differentially expressed ciRNAs were obtained by RNA-Sequencing. The identification of nervous-system-tissues specificity of ciRNA-Kat6b and the measurement of ciRNA-Kat6b and microRNA-26a (miRNA-26a) expression level were carried out by quantitative RT-PCR. The ciRNA-Kat6b that targets miRNA-26a and miRNA-26a that targets Kcnk1 were predicted by bioinformatics analysis and verified by in vitro luciferase reports test and in vivo experiments including Western-blot, immunofluorescence, and RNA-RNA immunoprecipitation. The correlation between neuropathic pain and ciRNA-Kat6b, miRNA-26a, or Kcnk1 was examined by the hypersensitivity response to heat and mechanical stimulus. RESULTS Peripheral nerve injury downregulated ciRNA-Kat6b in the dorsal spinal horn of male mice. Rescuing this downregulation blocked nerve injury-induced increase of miRNA-26a, reversed the miRNA-26a-triggered decrease of potassium channel Kcnk1, a key neuropathic pain player, in the dorsal horn, and alleviates CCI-induced pain hypersensitivities. On the contrary, mimicking this downregulation increased the miRNA-26a level and decreased Kcnk1 in the spinal cord, resulting in neuropathic pain-like syndrome in naïve mice. Mechanistically, the downregulation of ciRNA-Kat6b reduced the accounts of miRNA-26a binding to ciRNA-Kat6b, and elevated the binding accounts of miRNA-26a to the 3' untranslated region of Kcnk1 mRNA and degeneration of Kcnk1 mRNA, triggering in the reduction of KCNK1 protein in the dorsal horn of neuropathic pain mice. CONCLUSION The ciRNA-Kat6b/miRNA-26a/Kcnk1 pathway in dorsal horn neurons regulates the development and maintenance of neuropathic pain, ciRNA-Kat6b may be a potential new target for analgesic and treatment strategies.
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Affiliation(s)
- Ling Xie
- Jiangsu Province Key Laboratory of AnesthesiologyXuzhou Medical UniversityXuzhouChina
- Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application TechnologyXuzhou Medical UniversityXuzhouChina
- NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic DrugsXuzhouChina
- Department of AnesthesiologyThe Obstetrics and Gynecology Hospital of Fudan UniversityShanghaiChina
| | - Ming Zhang
- Jiangsu Province Key Laboratory of AnesthesiologyXuzhou Medical UniversityXuzhouChina
- Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application TechnologyXuzhou Medical UniversityXuzhouChina
- NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic DrugsXuzhouChina
| | - Qiaoqiao Liu
- Jiangsu Province Key Laboratory of AnesthesiologyXuzhou Medical UniversityXuzhouChina
- Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application TechnologyXuzhou Medical UniversityXuzhouChina
- NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic DrugsXuzhouChina
| | - Runa Wei
- Jiangsu Province Key Laboratory of AnesthesiologyXuzhou Medical UniversityXuzhouChina
- Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application TechnologyXuzhou Medical UniversityXuzhouChina
- NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic DrugsXuzhouChina
| | - Menglan Sun
- Jiangsu Province Key Laboratory of AnesthesiologyXuzhou Medical UniversityXuzhouChina
- Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application TechnologyXuzhou Medical UniversityXuzhouChina
- NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic DrugsXuzhouChina
| | - Qi Zhang
- Jiangsu Province Key Laboratory of AnesthesiologyXuzhou Medical UniversityXuzhouChina
- Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application TechnologyXuzhou Medical UniversityXuzhouChina
- NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic DrugsXuzhouChina
| | - Lingyun Hao
- Jiangsu Province Key Laboratory of AnesthesiologyXuzhou Medical UniversityXuzhouChina
- Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application TechnologyXuzhou Medical UniversityXuzhouChina
- NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic DrugsXuzhouChina
| | - Zhouya Xue
- Department of AnesthesiologyThe Yancheng First People's Hospital Affiliated to Xuzhou Medical UniversityYanchengChina
| | - Qihui Wang
- Jiangsu Province Key Laboratory of AnesthesiologyXuzhou Medical UniversityXuzhouChina
- Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application TechnologyXuzhou Medical UniversityXuzhouChina
- NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic DrugsXuzhouChina
| | - Li Yang
- Jiangsu Province Key Laboratory of AnesthesiologyXuzhou Medical UniversityXuzhouChina
- Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application TechnologyXuzhou Medical UniversityXuzhouChina
- NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic DrugsXuzhouChina
| | - Hongjun Wang
- Jiangsu Province Key Laboratory of AnesthesiologyXuzhou Medical UniversityXuzhouChina
- Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application TechnologyXuzhou Medical UniversityXuzhouChina
- NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic DrugsXuzhouChina
| | - Zhiqiang Pan
- Jiangsu Province Key Laboratory of AnesthesiologyXuzhou Medical UniversityXuzhouChina
- Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application TechnologyXuzhou Medical UniversityXuzhouChina
- NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic DrugsXuzhouChina
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Ślęczkowska M, Misra K, Santoro S, Gerrits MM, Hoeijmakers JGJ. Ion Channel Genes in Painful Neuropathies. Biomedicines 2023; 11:2680. [PMID: 37893054 PMCID: PMC10604193 DOI: 10.3390/biomedicines11102680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 09/28/2023] [Indexed: 10/29/2023] Open
Abstract
Neuropathic pain (NP) is a typical symptom of peripheral nerve disorders, including painful neuropathy. The biological mechanisms that control ion channels are important for many cell activities and are also therapeutic targets. Disruption of the cellular mechanisms that govern ion channel activity can contribute to pain pathophysiology. The voltage-gated sodium channel (VGSC) is the most researched ion channel in terms of NP; however, VGSC impairment is detected in only <20% of painful neuropathy patients. Here, we discuss the potential role of the other peripheral ion channels involved in sensory signaling (transient receptor potential cation channels), neuronal excitation regulation (potassium channels), involuntary action potential generation (hyperpolarization-activated cyclic nucleotide-gated channels), thermal pain (anoctamins), pH modulation (acid sensing ion channels), and neurotransmitter release (calcium channels) related to pain and their prospective role as therapeutic targets for painful neuropathy.
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Affiliation(s)
- Milena Ślęczkowska
- Department of Toxicogenomics, Maastricht University, 6229 ER Maastricht, The Netherlands;
- Department of Neurology, School of Mental Health and Neuroscience, Maastricht University Medical Centre+, 6229 ER Maastricht, The Netherlands
| | - Kaalindi Misra
- Laboratory of Human Genetics of Neurological Disorders, IRCCS San Raffaele Scientific Institute, INSPE, 20132 Milan, Italy; (K.M.); (S.S.)
| | - Silvia Santoro
- Laboratory of Human Genetics of Neurological Disorders, IRCCS San Raffaele Scientific Institute, INSPE, 20132 Milan, Italy; (K.M.); (S.S.)
| | - Monique M. Gerrits
- Department of Clinical Genetics, Maastricht University Medical Centre+, 6229 HX Maastricht, The Netherlands;
| | - Janneke G. J. Hoeijmakers
- Department of Neurology, School of Mental Health and Neuroscience, Maastricht University Medical Centre+, 6229 ER Maastricht, The Netherlands
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Doneddu PE, Pensato U, Iorfida A, Alberti C, Nobile-Orazio E, Fabbri A, Voza A. Neuropathic Pain in the Emergency Setting: Diagnosis and Management. J Clin Med 2023; 12:6028. [PMID: 37762968 PMCID: PMC10531819 DOI: 10.3390/jcm12186028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 09/04/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023] Open
Abstract
Neuropathic pain, traditionally considered a chronic condition, is increasingly encountered in the emergency department (ED), accounting for approximately 20% of patients presenting with pain. Understanding the physiology and key clinical presentations of neuropathic pain is crucial for ED physicians to provide optimal treatment. While diagnosing neuropathic pain can be challenging, emphasis should be placed on obtaining a comprehensive medical history and conducting a thorough clinical examination. Patients often describe neuropathic pain as a burning or shock-like sensation, leading them to seek care in the ED after ineffective relief from common analgesics such as paracetamol and NSAIDs. Collaboration between emergency medicine specialists, neurologists, and pain management experts can contribute to the development of evidence-based guidelines specifically tailored for the emergency department setting. This article provides a concise overview of the common clinical manifestations of neuropathic pain that may prompt patients to seek emergency care.
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Affiliation(s)
- Pietro Emiliano Doneddu
- Neuromuscular and Neuroimmunology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, MI, Italy
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072 Pieve Emanuele, MI, Italy
| | - Umberto Pensato
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072 Pieve Emanuele, MI, Italy
- Neurology and Stroke Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, MI, Italy
| | - Alessandra Iorfida
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072 Pieve Emanuele, MI, Italy
- Emergency Department, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, MI, Italy
| | - Claudia Alberti
- Neuromuscular and Neuroimmunology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, MI, Italy
| | - Eduardo Nobile-Orazio
- Neuromuscular and Neuroimmunology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, MI, Italy
- Department of Medical Biotechnology and Translational Medicine, Milan University, 20133 Milano, MI, Italy
| | - Andrea Fabbri
- Emergency Department AUSL Romagna, Presidio Ospedaliero Morgagni-Pierantoni, 47121 Forlì, FC, Italy
| | - Antonio Voza
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072 Pieve Emanuele, MI, Italy
- Emergency Department, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, MI, Italy
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49
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Luque-Sanchez K, Felix J, Bilbrey J, Restrepo L, Reeves M, McMahon LR, Wilkerson JL. Evaluation of novel epibatidine analogs in the rat nicotine drug discrimination assay and in the rat chronic constriction injury neuropathic pain model. ADVANCES IN DRUG AND ALCOHOL RESEARCH 2023; 3:11622. [PMID: 38389808 PMCID: PMC10880765 DOI: 10.3389/adar.2023.11622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 08/30/2023] [Indexed: 02/24/2024]
Abstract
Nicotine is the primary psychoactive component responsible for maintaining tobacco dependence in humans. Chronic pain is often a consequence of tobacco-related pathologies, and the development of a dual therapeutic that could treat chronic pain and tobacco dependence would be advantageous. Epibatidine reliably substitutes for nicotine in the drug discrimination assay, and is a potent analgesic, but has a side-effect profile that limits its therapeutic potential. Thus, considerable efforts to produce epibatidine derivatives are underway. Here we tested three epibatidine derivatives, 2'-fluoro-3'-(4-nitrophenyl)deschloroepibatidine (RTI-7527-102; i.e., RTI-102), 2'-fluorodeschloroepibatidine (RTI-7527-36; i.e., RTI-36), and 3'-(3″-dimethylaminophenyl)-epibatidine (RTI-7527-76; i.e., RTI-76) in both the rat nicotine drug discrimination assay as well as in the rat chronic constriction injury (CCI) of the sciatic nerve neuropathic pain model. Male and female Sprague-Dawley rats were trained on a fixed-ratio 10 schedule to discriminate nicotine (0.32 mg/kg base) from vehicle. All compounds dose-dependently substituted for nicotine, without significant decreases in response rates. In the discrimination assay the rank order potency was RTI-36 > nicotine > RTI-102 > RTI-76. Evidence suggests the α4β2* subtype is particularly important to nicotine-related abuse potential. Thus, here we utilized the antagonist dihydro-β-erythroidine (DHβE) to examine relative β2 subunit contribution. DHβE (3.2 mg/kg, s.c.) antagonized the discriminative stimulus effects of nicotine. However, relative to antagonism of nicotine, DHβE produced less antagonism of RTI-102 and RTI-76 and greater antagonism of RTI-36. It is likely that at nicotinic receptor subunits RTI-102, RTI-76 and RTI-36 possess differing activity. To confirm that the full discriminative stimulus of these compounds was due to nAChR activity beyond the β2 subunit, we examined these compounds in the presence of the non-selective nicotinic receptor antagonist mecamylamine. Mecamylamine (0.56 mg/kg, s.c.) pretreatment abolished nicotine-paired lever responding for all compounds. In a separate cohort, male and female Sprague-Dawley rats underwent CCI surgery and tested for CCI-induced mechanical allodynia via the von Frey assay. Each compound produced CCI-induced mechanical allodynia reversal. RTI-36 displayed higher potency than either RTI-102 or RTI-76. These novel epibatidine analogs may prove to be useful tools in the fight against nicotine dependence as well as novel neuropathic pain analgesics.
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Affiliation(s)
- Kevin Luque-Sanchez
- Department of Pharmacodynamics, College of Pharmacy, University of Florida, Gainesville, FL, United States
| | - Jasmine Felix
- Department of Pharmacodynamics, College of Pharmacy, University of Florida, Gainesville, FL, United States
| | - Joshua Bilbrey
- Department of Pharmacodynamics, College of Pharmacy, University of Florida, Gainesville, FL, United States
| | - Luis Restrepo
- Department of Pharmacodynamics, College of Pharmacy, University of Florida, Gainesville, FL, United States
| | - Morgan Reeves
- Department of Pharmacodynamics, College of Pharmacy, University of Florida, Gainesville, FL, United States
| | - Lance R McMahon
- Department of Pharmacodynamics, College of Pharmacy, University of Florida, Gainesville, FL, United States
- Department of Pharmaceutical Sciences, Texas Tech University Health Sciences Center, Amarillo, TX, United States
| | - Jenny L Wilkerson
- Department of Pharmacodynamics, College of Pharmacy, University of Florida, Gainesville, FL, United States
- Department of Pharmaceutical Sciences, Texas Tech University Health Sciences Center, Amarillo, TX, United States
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50
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Scarneo S, Zhang X, Wang Y, Camacho-Domenech J, Ricano J, Hughes P, Haystead T, Nackley AG. Transforming Growth Factor-β-Activated Kinase 1 (TAK1) Mediates Chronic Pain and Cytokine Production in Mouse Models of Inflammatory, Neuropathic, and Primary Pain. THE JOURNAL OF PAIN 2023; 24:1633-1644. [PMID: 37121498 PMCID: PMC10524186 DOI: 10.1016/j.jpain.2023.04.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 04/07/2023] [Accepted: 04/24/2023] [Indexed: 05/02/2023]
Abstract
The origin of chronic pain is linked to inflammation, characterized by increased levels of proinflammatory cytokines in local tissues and systemic circulation. Transforming growth factor beta-activated kinase 1 (TAK1) is a key regulator of proinflammatory cytokine signaling that has been well characterized in the context of cancer and autoimmune disorders, yet its role in chronic pain is less clear. Here, we evaluated the ability of our TAK1 small-molecule inhibitor, takinib, to attenuate pain and inflammation in preclinical models of inflammatory, neuropathic, and primary pain. Inflammatory, neuropathic, and primary pain was modeled using intraplantar complete Freund's adjuvant (CFA), chronic constriction injury (CCI), and systemic delivery of the catechol-O-methyltransferase (COMT) inhibitor OR486, respectively. Behavioral responses evoked by mechanical and thermal stimuli were evaluated in separate groups of mice receiving takinib or vehicle prior to pain induction (baseline) and over 12 days following CFA injection, 4 weeks following CCI surgery, and 6 hours following OR486 delivery. Hindpaw edema was also measured prior to and 3 days following CFA injection. Upon termination of behavioral experiments, dorsal root ganglia (DRG) were collected to measure cytokines. We also evaluated the ability of takinib to modulate nociceptor activity via in vitro calcium imaging of neurons isolated from the DRG of Gcamp3 mice. In all 3 models, TAK1 inhibition significantly reduced hypersensitivity to mechanical and thermal stimuli and expression of proinflammatory cytokines in DRG. Furthermore, TAK1 inhibition significantly reduced the activity of tumor necrosis factor (TNF)-primed/capsaicin-evoked DRG nociceptive neurons. Overall, our results support the therapeutic potential of TAK1 as a novel drug target for the treatment of chronic pain syndromes with different etiologies. PERSPECTIVE: This article reports the therapeutic potential of TAK1 inhibitors for the treatment of chronic pain. This new treatment has the potential to provide a greater therapeutic offering to physicians and patients suffering from chronic pain as well as reduce the dependency on opioid-based pain treatments.
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Affiliation(s)
- Scott Scarneo
- Center for Translational Pain Medicine, Department of Anesthesiology, Duke University School of Medicine, Durham, North Carolina; Department of Pharmacology and Cancer Biology, Duke University School of Medicine, Durham, North Carolina; EydisBio Inc., Department of Research and Development Durham, North Carolina.
| | - Xin Zhang
- Center for Translational Pain Medicine, Department of Anesthesiology, Duke University School of Medicine, Durham, North Carolina; Department of Anesthesiology, Nanjing Medical University Affiliated Wuxi People's Hospital, Wuxi, Jiangsu, China
| | - Yaomin Wang
- Center for Translational Pain Medicine, Department of Anesthesiology, Duke University School of Medicine, Durham, North Carolina
| | - Jose Camacho-Domenech
- Center for Translational Pain Medicine, Department of Anesthesiology, Duke University School of Medicine, Durham, North Carolina; Department of Pharmacology and Cancer Biology, Duke University School of Medicine, Durham, North Carolina
| | - Jennifer Ricano
- Center for Translational Pain Medicine, Department of Anesthesiology, Duke University School of Medicine, Durham, North Carolina
| | - Philip Hughes
- Department of Pharmacology and Cancer Biology, Duke University School of Medicine, Durham, North Carolina; EydisBio Inc., Department of Research and Development Durham, North Carolina
| | - Tim Haystead
- Department of Pharmacology and Cancer Biology, Duke University School of Medicine, Durham, North Carolina; EydisBio Inc., Department of Research and Development Durham, North Carolina
| | - Andrea G Nackley
- Center for Translational Pain Medicine, Department of Anesthesiology, Duke University School of Medicine, Durham, North Carolina; Department of Pharmacology and Cancer Biology, Duke University School of Medicine, Durham, North Carolina
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